The effect of cervical dilatation by laminaria tent in first trimester legal abortions on blood loss related to fibrinolytic activity in the decidua and placenta

Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.

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Cervical dilatation in late first trimester termination by prostaglandin, hylase and isogel

Prostaglandins and Medicine ◽

10.1016/0161-4630(81)90070-7 ◽

1981 ◽

Vol 6 (4) ◽

pp. 381-387 ◽

Cited By ~ 2

Author(s):

A.V. Mandlekar ◽

A.C. Ganguli ◽

U.R. Krishna ◽

V.N. Purandare

Keyword(s):

First Trimester ◽

Cervical Dilatation

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Cervical dilatation with 16, 16 dimethyl PGE2 p-benzaldehyde semicarbazone ester prior to vacuum aspiration in first trimester nulliparae

Prostaglandins ◽

10.1016/0090-6980(77)90012-0 ◽

1977 ◽

Vol 13 (2) ◽

pp. 333-338 ◽

Cited By ~ 15

Author(s):

S.M.M. Karim ◽

S.S. Ratnam ◽

V. Selvadurai ◽

W. Wun ◽

R.N.V. Prasad

Keyword(s):

First Trimester ◽

Cervical Dilatation ◽

Vacuum Aspiration

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Intraoperative Blood Loss during Induced Abortion: A Comparison of Anesthetics

Anesthesiology Research and Practice ◽

10.1155/2018/4051896 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Camille A. Clare ◽

Gabrielle E. Hatton ◽

Neela Shrestha ◽

Michael Girshin ◽

Andre Broumas ◽

...

Keyword(s):

Blood Loss ◽

Retrospective Chart Review ◽

First Trimester ◽

Induced Abortion ◽

Anesthetic Technique ◽

Anesthetic Techniques ◽

Intraoperative Blood Loss ◽

Anesthetic Agents ◽

Dilatation And Curettage ◽

Increased Risk

Objective. To determine whether there is a difference in intraoperative bleeding with inhalational versus noninhalational anesthetic agents for patients undergoing suction dilatation and curettage for first-trimester induced abortion.Methods. This is an IRB-approved retrospective chart review of the electronic medical records of patients undergoing induced abortion at gestational ages between 5 0/7 and 14 0/7 weeks of pregnancy at the New York City Health + Hospitals/Metropolitan. The records of 138 patients who underwent suction dilatation and curettage for induced abortion between June 2012 and June 2014 were reviewed for an association between anesthetic technique and intraoperative hemorrhage. Twenty patients received inhalational anesthetic agents, while 118 received intravenous anesthetics. Blood loss was estimated by the operating gynecologists.Results. The mean intraoperative blood loss for inhalational anesthetics (113.6 ml) was significantly higher than with noninhalational agents (40.2 ml) (p=0.007). Age, body mass index, and gestational age were not statistically different between the groups; the number of methylergonovine doses at induced abortion trended higher with inhalation anesthetics.Conclusions. The difference in blood loss between the two types of anesthetic techniques was statistically significant. These findings may be important for patients with significant anemia or at an increased risk of bleeding, such as those with unrecognized coagulopathies.

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