Analgesia for Medically Induced Second Trimester Termination of Pregnancy: A Randomized Trial

Abstract Background Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy. Objective Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University. Methods This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria. Results This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group). Conclusion s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.

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Prevalence and determinants associated with second trimester termination of pregnancy in Harari city, Ethiopia; Cross sectional study.

10.21203/rs.3.rs-356440/v1 ◽

2021 ◽

Author(s):

Murad Mohammed ◽

Million Wesenu

Keyword(s):

Logistic Regression ◽

Cross Sectional Study ◽

Termination Of Pregnancy ◽

Reproductive Age ◽

Second Trimester ◽

Sectional Study ◽

Cross Sectional ◽

Abortion Care ◽

Post Abortion ◽

Age Category

Abstract Background: Abortion is a termination of pregnancy before the fetus has become viable, i.e., capable of independent existence once delivered by the mother. The purpose of this study was to assess the prevalence and determinants associated with second trimester termination of pregnancy among the women in the reproductive age. Methods: Cross sectional study, design was conducted from September 1-30, 2020. Eight hundreds thirty-five sample of women with induced abortion complication were used. The data were entered into statistical package and service solutions (SPSS) version 23.0 for cleaning and data analysis. Chi-square test of association was used to test the association between the response variable. Binary logistic regression was employed for variables one by one in bivariate logistic regression to determine the significant association between response variables and predictors at p-value 0.15. A 95% confidence interval (CI) and level of significance less than 0.05 were used to determine statistical significance. Results: The prevalence of second trimester termination of pregnancy in the reproductive Age (15-49 years) was found to be 18.2%. As a result multivariable logistic regression model, women with age category 20-24 years [Adjusted odds ratio(AOR)=2.055, 95% CI=1.102-3.831], age category 30-34 years [AOR=3.084, 95%CI=1.348-7.056] , age category greater than or equal to 35 had adjusted odds ratio(AOR=3.021, 95% CI=1.199-7.610), having safe abortion care (AOR=0.294, 95%CI=0.132-0.656), taking treatment in health care/hospital (AOR=2.385, 95% CI=1.057-5.382) and repeatedly acceptor of post-abortion contraception (AOR=0.533, 95%CI=0.291-0.979) were potential determinants associated with women’s in the reproductive age with second trimester termination of pregnancy. Conclusions: Second trimester termination of pregnancy is strongly affected by age of mother, abortion care, place of managed abortion and post-abortion contraception. Strategies on Antenatal care and task-oriented services should be given to community level about the second trimester medical termination of pregnancy to decrease further complications and maternal mortality.

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