title: Sequential use of Foley catheter with misoprostol for second trimester pregnancy termination in women with and without caesarean scars: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study is to evaluate the effectiveness and safety of misoprostol and Foley catheter in second trimester termination in women with and without caesarean section (CS) scars.
  
  
  METHODS
  Women with an indication for pregnancy termination between 14 and 22 completed weeks of gestation were included to the study. Enrolled women were allocated into three groups: (1) women with no history of CS, (2) women with one CS and (3) women with ≥2 CS. Study consisted 337 patients (233 group 1, 88 group 2 and 16 group 3). Misoprostol and Foley catheter were used sequentially. The primary outcome was the induction to abortion interval. Secondary outcomes were the successful vaginal abortion rate, the percentage of abortions in 24 h and the rates of surgical removal of the placenta, Foley catheter use and major maternal complications (transfusions, thromboembolic events, uterine rupture and death).
  
  
  RESULTS
  Demographic characteristics were comparable. All study outcomes were statistically similar among groups. There was no major maternal complication among all patients.
  
  
  CONCLUSIONS
  Sequential use of misoprostol and Foley catheter is safe and effective in second trimester pregnancy termination for patients with and without CS scars.
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Eskisehir Osmangazi University , Eskisehir , Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Velipasaoglu
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Eskisehir Osmangazi University , Eskisehir , Turkey.
authors.forename: Cem Yagmur
authors.initials: CY
authors.lastname: Ozdemir
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Eskisehir Osmangazi University , Eskisehir , Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Ozek
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Eskisehir Osmangazi University , Eskisehir , Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ayaz
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Eskisehir Osmangazi University , Eskisehir , Turkey.
authors.forename: Huseyin Mete
authors.initials: HM
authors.lastname: Tanir
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D002585:Cesarean Section; D002921:Cicatrix / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D011183:Postoperative Complications; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol
keywords: Foley catheter; Medical abortion; misoprostol; uterine rupture; uterine scar