SECOND-TRIMESTER ABORTION AFTER VAGINAL TERMINATION OF PREGNANCY

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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Termination of pregnancy by “super coils”: Morbidity associated with a new method of second-trimester abortion

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(15)31284-9 ◽

1973 ◽

Vol 116 (3) ◽

pp. 297-304 ◽

Cited By ~ 5

Author(s):

Gary S. Berger ◽

Judith P. Bourne ◽

Carl W. Tyler ◽

Richard J. Haber ◽

Kristine Knisely ◽

...

Keyword(s):

Termination Of Pregnancy ◽

New Method ◽

Second Trimester ◽

Trimester Abortion ◽

Second Trimester Abortion

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SECOND-TRIMESTER ABORTION AFTER VAGINAL TERMINATION OF PREGNANCY

The Lancet ◽

10.1016/s0140-6736(72)90995-6 ◽

1972 ◽

Vol 299 (7763) ◽

pp. 1278-1279 ◽

Cited By ~ 97

Author(s):

CharlesS.W. Wright ◽

Stuart Campbell ◽

John Beazley

Keyword(s):

Termination Of Pregnancy ◽

Second Trimester ◽

Trimester Abortion ◽

Second Trimester Abortion

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Young age and termination of pregnancy during the second trimester are risk factors for repeat second-trimester abortion

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.03.004 ◽

2010 ◽

Vol 203 (2) ◽

pp. 107.e1-107.e7 ◽

Cited By ~ 16

Author(s):

Maarit J. Mentula ◽

Maarit Niinimäki ◽

Satu Suhonen ◽

Elina Hemminki ◽

Mika Gissler ◽

...

Keyword(s):

Risk Factors ◽

Young Age ◽

Termination Of Pregnancy ◽

Second Trimester ◽

Trimester Abortion ◽

Second Trimester Abortion

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Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180455 ◽

2018 ◽

Vol 7 (3) ◽

pp. 888

Author(s):

Abhijeet Kumar ◽

Raju Agarwal

Keyword(s):

Side Effects ◽

Failure Rate ◽

Pregnancy Termination ◽

Termination Of Pregnancy ◽

Second Trimester ◽

Trimester Abortion ◽

Trimester Pregnancy ◽

Second Trimester Pregnancy ◽

Second Trimester Abortion ◽

Vaginal Misoprostol

Background: The addition of dinoprostone gel (PGE2) to standard regimen of second trimester abortion using vaginal misoprostol (PGE1) reduces failure rate and decrease induction abortion time interval. We evaluated the role and efficacy of vaginal dinoprostone gel with vaginal misoprostol in women undergoing second trimester abortion. Objective of present study was to assess the safety and effectiveness of vaginal dinoprostone gel plus vaginal misoprostol for second trimester termination of pregnancy.Methods: This study was a prospective cohort involving 100 women with 12-20 weeks gestation requesting termination of pregnancy. In study group 0.5mg dinoprostone gel applied vaginally followed by 400µg misoprostol every four hourly (max 3 doses) after six hours of dinoprostone gel application. The mean age of the women study was 27.2 years and mean gestational age was 18.9 weeks. The primary effectiveness of the study was the efficacy of the treatment to terminate pregnancy at 20 hrs. Secondary outcomes were induction abortion interval, failure rate, side effects. statistical analysis of study was carried out using chi square test.Results: At 20 hours, the complete abortion rate was 100%. Within 16 hours 98% women aborted without any significant side effects. Mean induction abortion interval was 14.56 hours.Conclusions: Combination of vaginal dinoprostone gel (PGE2) plus misoprostol (PGE1) is effective, safe and alternate method for second trimester pregnancy termination with. In this protocol induction to abortion interval time is less as compared to other methods of second trimester pregnancy termination.

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Second Trimester Abortion practices in Eastern Hilly District of Nepal: A Cross-Sectional Study

Nepal Medical Journal ◽

10.37080/nmj.171 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Prabhu Sah ◽

Sangita Mishra ◽

Binod Singh ◽

Anju Deo ◽

Rinku Shah

Keyword(s):

Cross Sectional Study ◽

Termination Of Pregnancy ◽

Fiscal Year ◽

Health Management Information System ◽

Second Trimester ◽

Sectional Study ◽

Trimester Abortion ◽

Cross Sectional ◽

Safe Abortion ◽

Second Trimester Abortion

Introduction: Second-trimester abortion comprises 10-15% of total cases worldwide because of maternal disease, fetal anomalies, and delay in obtaining first trimester services during unintended pregnancies. The availability of legal safe abortion services with skilled hands is limited in rural hilly areas of Nepal. Unsafe and delays in seeking abortion services in resources poor countries like Nepal are contributing to maternal mortality and morbidity. This study aims to describe the demographic profile of patients, indications, and methods of second-trimester abortion with possible complications and family planning acceptance in the rural hilly areas of Nepal. Methods: A retrospective cross-sectional study was conducted at Ilam District Hospital in Province 1 of Nepal. The study sample comprises 75 patients who were admitted for abortion services in 1 fiscal year period from 16th July 2017 to 15th July 2018. Data for all the patients who received second-trimester abortion services were retrieved from Health Management Information System (HMIS) logbook maintained by the Hospital. Descriptive analysis was performed. Ethical approval for this study was obtained from the Nepal Health Research Council (Ref. No- 1921). Results: Most common age group seeking second-trimester abortion were 20-24 years(26.66%) and the majority of women who participated in this study were literate up to secondary level education(58.66%). Most participants belonged to janajati/adibasi caste(73.33%) and were from Ilam districts(72%).Most of the cases were in the early second trimester (62.66%) and were multiparous (60%). Common indications for termination of pregnancy were mental/maternal cause(82.66%) and medical induction was most (69.33%) common method. No major complications were found following abortion. The majority of participants chose short-term contraception (36%) following the termination of pregnancy. Conclusions: Awareness and availability of legal safe abortion services at local health facilities can reduce delays in seeking abortion services, prevent unsafe abortion practices, and reduce maternal morbidity and mortality.

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Mifepristone and Misoprostol Vs Misoprostol Alone in Second Trimester Termination of Pregnancy

Journal of Nepal Medical Association ◽

10.31729/jnma.3690 ◽

2018 ◽

Vol 56 (213) ◽

pp. 856-860

Author(s):

Deepa Shah ◽

Pappu Rijal ◽

Achala Thakur ◽

Rubina Rai

Keyword(s):

Side Effects ◽

Termination Of Pregnancy ◽

Second Trimester ◽

Trimester Abortion ◽

Highly Effective ◽

Group A ◽

Complete Failure ◽

Second Trimester Abortion ◽

The Difference ◽

Group B

Introduction: During the last decade, medical methods for second trimester abortion have considerably improved and become safe and more accessible. The combination of mifepristone and misoprostol is now an established and highly effective method for second trimester abortion. But where mifepristone is not available or affordable, misoprostol alone has also been shown to be effective. The objective of this study is to compare the efficacy of mifepristone with misoprostol and misoprostol alone for second trimester termination of pregnancy. Methods: It is a comparative study conducted on 60 patients from 13 to 18 weeks of gestation admitted for second trimester termination on legal indications. Results: Mean induction abortion interval was comparable in both the groups. Of the 30 cases in each group, nine cases in each Group A and six cases in Group B had incomplete/failed expulsion. Among these 15 cases, only nine required check curettage for complete evacuation while others received oxytocics only for completion. The distribution of these cases was also comparable in both the groups. Only one patient in Group B had complete failure of expulsion and underwent surgical evacuation. However, the difference in dosage of misoprostol required for complete expulsion and incidence of side effects were significantly higher in the group B. Conclusions: Mifepristone and misoprostol combined together is now an established, highly effective and safe method for medical method of second trimester termination. However, when mifepristone is not available or affordable, misoprostol alone can also be used effectively, although a higher total dose is needed and side effects are higher than with the combined regimen.

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