Induction of Abortion in the Second Trimester by Misoprostol or Misoprostol with Letrozole

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ashraf Mohamed Farouk Kortam ◽  
Tarek Aly Raafat ◽  
Rehab Mohamed Abd El Rahman ◽  
Amir Hamdy Abd El Hady Mahfouz
Keyword(s):  
Maternity Hospital ◽  
Abortion Rate ◽  
Termination Of Pregnancy ◽  
Control Group ◽  
Second Trimester ◽  
Exclusion Criteria ◽  
Trimester Abortion ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Peripheral Conversion

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.

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

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.

scholarly journals Comparative effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen of mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion

2018 ◽  
Vol 7 (6) ◽  
pp. 2449
Author(s):  
Arunima Saini ◽  
Preet Kamal Bedi ◽  
Nisha Bhagat
Keyword(s):  
Gestational Age ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Simultaneous Administration ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Group A ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Group B

Background: In second trimester abortion, medical methods are preferred. Prostaglandins are the most widely used. Amongst them, misoprostol is the most commonly used. Thus, the study was conducted to delineate the effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion.Methods: It was a prospective, single centered, comparative study conducted on 50 patients in Department of Obstetrics and Gynaecology, GMC, Amritsar coming for second trimester abortion, either elective or emergency, with gestational age between 12-20 weeks. Initially, 53 patients were enrolled in the study, 3 patients dropped out at different stages of study. Finally, 50 patients were enrolled and divided into two groups of 25 patients each by 1:1 randomization. In Group-A, mifepristone 200 mg orally along with misoprostol 600µg vaginally were given simultaneously, followed by 400 µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Group-B initially received mifepristone 200 mg per oral followed by 12 hours later misoprostol 400µg vaginally and then 400µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Primary outcome measure was effectiveness of regimen in complete abortion, which was confirmed on pelvic ultrasound 1-week after the last dose. Secondary outcome measure was to compare the induction abortion interval (IAI), dose of misoprostol required and adverse drug reaction (ADR) among both the regimens. P-value <0.05 was taken as statistically significant.Results: Mean age in Group-A was 25.68±3.79 years while in Group-B was 23.40±2.73 years. Both the regimens had success rate of 76% for complete abortion. However, IAI in Group-A was 5.9±4.47 hours whereas in Group-B was 9.6±5.07 hours, which was statistically significant (p= 0.009). A statistically significant difference was also observed in the mean dose of misoprostol between two groups that is, 1000±200µg and 1425±437.41µg respectively (p=0.01). Gestational age was related to IAI from 13 to 17.6 weeks in both groups (p=0.01) while no significant relation was seen between them in more than 17.6 weeks of gestation (p=0.63).Conclusions: Simultaneous administration of mifepristone and misoprostol showed better results than interval regimen in term of significant lesser induction abortion interval, lower dosages of misoprostol required with comparable success rates.

Vaginal misoprostol for early second-trimester abortion

1998 ◽  
Vol 3 (2) ◽  
pp. 93-98 ◽  
Author(s):  
J. Ll. Carbonell ◽  
L. Valera ◽  
A. Velazco ◽  
R. Tanda ◽  
C. Sánchez
Keyword(s):  
Second Trimester ◽  
Trimester Abortion ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol

scholarly journals Surgical abortion in second trimester: Initial experiences in Nepal

1970 ◽  
Vol 8 (2) ◽  
pp. 169-172 ◽  
Author(s):  
V Shrivastava ◽  
L Bajracharya ◽  
S Thapa
Keyword(s):  
Unwanted Pregnancy ◽  
Maternity Hospital ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Safe Abortion ◽  
The People ◽  
Second Trimester Abortion ◽  
Completed Family Size ◽  
A Prospective Study ◽  
Reproductive Aged Women

Introduction: In spite of legalising abortion and making safe abortion available at affordable price at accessible distance to almost everyone, unsafe abortion especially second trimester abortion is still a big health problem in Nepal. Objective: The objective of the study is to find the demographic profile, reasons for seeking abortion and to see the effectiveness of Misoprostol in preparing the cervix. Materials and methods: A prospective study was done in the two second trimester abortion trainings conducted in Maternity hospital, Kathmandu. Total 57 clients had second trimester abortion performed. Information was collected from structured questionnaire and then data was analysed. Results: Commonest reason for seeking abortion was, multiparity (61.4%). Common reasons for second trimester abortion were, completed family size with unwanted pregnancy (61.4%), unwanted pregnancy in married (10.52%) unwanted pregnancy in unmarried (5.26%). Conclusions: Second trimester abortion is one of the most common procedures performed in reproductive-aged women and when performed by a skilled provider in the appropriate setting, it is one of the safest surgeries, if it is well supported by change in policy of the country and acceptability of the people. Key words: Maternal death; Safe abortion; Second trimester abortion DOI: 10.3126/kumj.v8i2.3552 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 169-172

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

1973 ◽  
Vol 116 (3) ◽  
pp. 297-304 ◽  
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

scholarly journals Comparative evaluation of simultaneous administration of mifepristone and misoprostol; and misoprostol alone for induction of second trimester abortion

2018 ◽  
Vol 7 (7) ◽  
pp. 2728
Author(s):  
Ankita Jain ◽  
Arpit Agarwal
Keyword(s):  
Comparative Evaluation ◽  
Control Group ◽  
Study Group ◽  
Simultaneous Administration ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Dose Regime ◽  
Second Trimester Abortion ◽  
The Mean ◽  
Better Than

Background: The present study was conducted with the aim to assess the safety and efficacy of misoprostol alone and misoprostol with simultaneous mifepristone for second trimester termination of pregnancy.Methods: The study was conducted on 160 cases, divided in two groups of 80 cases each. In the study group 200 mg mifepristone and 200 μgm misoprostol given together on admission followed by miso every 3 hrs upto a maximum of 8 doses or until the abortion occurs, whichever occurs early. In the control group only miso was given in the same dose regime. If abortion did not occur within this duration it was considered failure of method. The results were analysed.Results: The success rate in first regimen was 98%. Mean induction abortion interval was significantly shorter in the study group, 8.62±1.96 h as compared to 14.5±3.01 h in the control group. The mean dose of the misoprostol required was significantly less in study group. The side effects like nausea, vomiting, fever, abdominal cramps, diarrhoea were observed more in control group (30%) in comparison to study group (12.1%).Conclusions: Mifepristone with simultaneous misoprostol is better than misoprostol alone and there is no need to wait for 24 hr after mifepristone for administration of misoprostol.

scholarly journals Second Trimester Abortion with Vaginal Misoprostol: Is There Any Advantage with Prior Mifepristone Priming? A Comparative Study

2012 ◽  
Vol 4 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Partha Mukhopadhyay ◽  
Tara Sankar Bag ◽  
Amit Kyal ◽  
Anup Bhuniya ◽  
Tushar Kanti Saha
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Careful Examination ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Group A ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Ideal Method

ABSTRACT Objective Second trimester medical termination of pregnancy (MTP) can be done by surgical or nonsurgical methods or by various combinations of the two. Every method has its advantages and disadvantages. An ideal method would be one which was safe, quick and 100% effective, inexpensive and without any immediate or late side-effects. However, in the absence of such, various methods in synergistic combinations have been tried to come close to an ideal method. The successes of medical method now appear to be useful in MTP even in second trimester of pregnancy. Our objective is to investigate the effectiveness of only vaginal misoprostol and compare with oral mifepristone plus vaginal misoprostol in second-trimester induction abortions (≥12 and ≤20 weeks). Methods The patients are selected after careful examination and necessary investigations were divided into group A (n = 62) which received 400 μg of vaginal misoprostol followed by 200 μg vaginal misoprostol 4 hourly till expulsion of fetus or a maximum dose of 2000 μg and group B (n = 60) which received 200 mg of oral mifepristone followed 48 hours later by vaginal misoprostol as in group A. Main outcomes measured were efficacy, blood loss, induction-abortion interval and complication. Results The present study showed that the both methods were effective in 2nd trimester MTP. Average blood loss was lesser in group B (131.66 ml) compared to group A (150 ml). Induction abortion interval was shorter in group B (6.62 hours) than in group A (12.19 hours). Ninty percent of group B and 80.7% of group A had no complications. Success rate was higher in group B. Conclusion Therefore, in our study, pretreatment mifepristone followed by misoprostol was found to be a very effective regimen for 2nd trimester abortion with lesser complications and higher efficacy. How to cite this article Mukhopadhyay P, Bag TS, Kyal A, Bhuniya A, Saha TK. Second Trimester Abortion with Vaginal Misoprostol: Is There Any Advantage with Prior Mifepristone Priming? A Comparative Study. J South Asian Feder Obst Gynae 2012;4(1):25-27.

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