Standardizing Second-Trimester Medical Termination: Effects on Clinical Outcomes

2018 ◽  
Vol 35 (08) ◽  
pp. 791-795
Author(s):  
Michelle Wyatt ◽  
Mary Tolcher

Objective The objective of this study was to evaluate length of induction and postdelivery complications before and after implementation of a standardized approach to second-trimester medical termination of pregnancy. Study Design This was a retrospective cohort study of all women undergoing medical termination of pregnancy between 130/7 and 266/7 weeks of gestation at a single, academic institution from July 1, 2012, through June 30, 2015. The primary outcome was the time from the start of induction of labor to delivery of the fetus. Postdelivery complications including the need for dilation and curettage (D&C), blood transfusion, and readmission to the hospital were secondary outcomes of interest. Results A total of 62 women met inclusion criteria; 38 before and 24 after the intervention. There were no differences in measured baseline characteristics (p > 0.05). There was a significant decrease in induction time after the intervention (12.3 compared with 8.6 hours, p = 0.031). There was no significant difference in rates of D&C or other measured complications (p > 0.05). Conclusion Implementation of a standardized clinical guideline for second-trimester medical termination was associated with a decrease in length of induction. There was no significant difference in need for D&C or postdelivery complications; however, we were underpowered for these secondary outcomes.

2003 ◽  
Vol 63 (07) ◽  
pp. 648-650
Author(s):  
P. Greco ◽  
M. Scioscia ◽  
A. Vimercati ◽  
L. Selvaggi

2017 ◽  
pp. 20-25
Author(s):  
S. V. Apresyan ◽  
V. I. Dimitrova ◽  
O. A. Slyusareva

The article describes the specific features of termination of progressive uterine pregnancy in the II trimester. It was found that the efficacy of medical abortion in the II trimester of pregnancy is 94–98%. High efficacy, low incidence of side effects or early and late complications and economic feasibility demonstrate that the method is promising and safe; therefore, it can be recommended as a priority when choosing a method for medical termination of pregnancy in the II trimester.


2021 ◽  
Vol 28 (11) ◽  
pp. 1645-1649
Author(s):  
Komal Devi ◽  
Shazia Aftab ◽  
Reena ◽  
Huma Baloch ◽  
Devi Kumari ◽  
...  

Objective: To determine efficacy of misoprostol given in 4 hourly versus 6 hourly intervals in second trimester for termination of pregnancy. Study Design: Cross sectional study. Setting: Study was conducted at the department of Obstetrics and Gynecology of Jinnah Medical and Dental College Karachi Allied Hospital. Period: March to August 2020. Material & Methods: Pregnant ladies in second trimester, requiring abortion due to medical reasons, were planned for termination of pregnancy. Two groups were made. Patients in Group-A were given misoprostol 4 hourly and those in Group-B were given misoprostol 6 hourly. Similar dose of drug (200ug) was given in both groups and monitoring was done. If abortion done in 48 hours, it was considered effective abortion and if not happened in 48 hours, it was considered a failed abortion. Consent was taken from all ladies in study group. Ethical approval was taken from ethical review committee. Results: Total 140 cases were studied, 70 cases in each group, A & B. Age range of cases was 16-40 years with mean age of 26.4±3.5 years. Most of the cases were having age between 20-30 years (63.5%). Group-A (N=70) was given misoprostol 4 hourly, where abortion was done in 94.3% cases while abortion failed in 5.7% cases. In Group-B (N=70) misoprostol was given 6 hourly, induced abortion in 82.8% and failed in 17.1% cases. Conclusion: Misoprostol dose of 20ug given via vaginal route is much effective drug for medical termination of pregnancy when given 4 hourly instead 6 hourly, with low failure rate.


Author(s):  
Meena Bhati Salvi ◽  
Madhubala Chauhan

Intrauterine retention of fetal bone is a rare complication of second trimester termination of pregnancy. These patients may present with abnormal uterine bleeding, dysmenorrhea and secondary infertility. In this case pelvic pain was the only symptom. A 32-year-old woman with history of second trimester medical termination of pregnancy was examined. Pelvic ultrasound revealed retained products of conception. After surgical evacuation, intrauterine retained fetal bone was identified to be the cause of pelvic pain. In patients with history of second trimester abortion, cause of pelvic pain should be properly evaluated.


2020 ◽  
Vol 27 (01) ◽  
pp. 46-51
Author(s):  
Shamas un Nisa ◽  
Farzana Razaq ◽  
Sadaf un Nisa

Termination of Pregnancy (TOP), in our country is carried out only when considerable danger to a fetus due to congenital abnormalities, intrauterine fetal loss or when maternal life is under threat. The principle concerns in providing second trimester termination include safety, efficacy, simplicity, low-cost, and fast acting with minimal side effects. Objectives: To compare the efficacy in term of complete abortion within 48 hours between protocol-I (200 µg misoprostol 4 hourly) versus protocol-II (200 µg misoprostol 6 hourly) for second trimester (14-24 weeks) medical termination of pregnancy. Study Design: Randomized controlled trial. Settings: Gynecology & obstetrics unit-II, Bahawal Victoria Hospital (BVH) Bahawalpur. Period: From 1st July 2017 to 30th June 2018. Material & Method: A total of 182 patients meeting the inclusion criteria were included in study. Ninety one patients were included in group-A and 91 patients were included in group-B.  Women allocated to group-A was given misoprostol 200µg every 4 hour. Similar drug and dose were administered to women of group-B intra-vaginally, 6 hourly. Patients in both groups were monitored up to 48. If abortion occurred within 48 hours of induction, it was labeled as effective abortion otherwise it was regarded as failed abortion. Results: The mean age in group-A was 26.71 years 25.49 years in Group-B. In group-A, 89 (97.8%) patients showed efficacy (abortion within 48 hours) and in group-B, 74 (81.32%) patients showed efficacy to misoprostol. Conclusion: The regimen of using 200μg of vaginal misoprostol 4 hourly is more efficacious and quick for 2nd trimester TOP with fewer side effects when compared to 200μg of vaginal misoprostol 6 hourly.


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