scholarly journals Misoprostol only or in combination with intra cervical Foley’s catheter for termination of the second trimester demise pregnancy in patient with previous caesarean sections

2020 ◽  
Vol 11 (6) ◽  
Author(s):  
Hend S Saleh ◽  
Mohamed El-Husseny El Kadosi ◽  
El Kadosi
Keyword(s):  
P Value ◽  
Safe Procedure ◽  
Second Trimester ◽  
Trimester Pregnancy ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Second Trimester Pregnancy ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Scarred Uterus

Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value>0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.

scholarly journals COMPARATIVE STUDY BETWEEN COMBINED USE OF INTRACERVICAL FOLEY CATHETER WITH VAGINAL MISOPROSTOL VERSUS VAGINAL MISOPROSTOL FOR MID TRIMESTER ABORTIONS IN PATIENTS WITH PREVIOUS CAESAREAN SECTIONS

2021 ◽  
Vol 9 (4) ◽  
pp. 634-640
Author(s):  
Kanchan Sharma ◽  
◽  
Ranideepa a ◽  
Anamika b ◽  
◽  
...  
Keyword(s):  
Foley Catheter ◽  
Termination Of Pregnancy ◽  
P Value ◽  
Second Trimester ◽  
Skeletal Malformation ◽  
Screening Programs ◽  
Group I ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Vaginal Misoprostol

Background:There is a gradual increase in second-trimester abortion because of wide scale introduction of prenatal screening programs detecting women whose pregnancies are complicated by serious fetal abnormalities suchas aneuploidy, cardiovascular and skeletal malformation. It constitutes 10-15% of all induced abortions.With the global trend of raised cesarean section rate, obstetricians are faced with the challenge of termination of pregnancy in women with a scarred uterus.Termination of pregnancy in second trimester is associated with much more morbidity and mortality than when it is done in the first trimester. The various methods for second trimester termination of pregnancy are still controversial and the search for the ideal method which is the safest, easiest, cheapest and most effective is still going on. Search for alternative and effective method is the need of hour. In our study, we aimed at assessing the effectiveness and safety of intracervical foleys catheter with vaginal misoprost and comparing it with the vaginal misoprost for mid trimester abortions in patients with previous caesarean. Methods: This was a prospective randomized controlled trial conducted on 108 women undergoing mid trimester abortions at Patna medical college and hospital in 2019. Patients were randomly allocated in 2 groups Group I ( intracervical foleys and Misoprostol group): Intracervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (200 μg) 6 hourly intravaginally was used. Group II (misoprostol group): moistened misoprostol tablets (200 μg) 6 hourly inserted vaginally. Procedure efficacy (defined as complete abortion within 48 hours of first dose of misoprostol), safety and reduction in side effects ,acceptability, dose of misoprost required were assessed in both the groups. Results:The induction to abortion interval was 24.16 ± 1.52 hours in the combined group compared to 45.76 ± 1.63 hours in the misoprostol group (P value<0.021) with success rate of 96% in the combined group and 80 % in misoprostol group. Total dose of misoprostol required in combined group was (682.33+_ 245) micrograms and (1100 +_ 212) micrograms in misoprost group with p value < 0.001 No significant difference as regard occurrence of advere effects between the two groups. Conclusions:Combined use of intracervical foley catheter and vaginal misoprostol is a novel safe, effective and acceptable method for termination of second trimester in patients with previous caesarean sectionpregnancy.

scholarly journals SECOND TRIMESTER PREGNANCY

2011 ◽  
Vol 18 (04) ◽  
pp. 581-586
Author(s):  
DR HEMLATA ◽  
QAMAR-UR- NISA ◽  
RUBINA SOLANGI ◽  
Suresh Kumar Rathi ◽  
Habib Ullah
Keyword(s):  
Gestational Age ◽  
Safety Data ◽  
Second Trimester ◽  
Trimester Pregnancy ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Second Trimester Pregnancy ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Objective: To compare clinical efficacy and side effects of oral misoprotol with vaginal misoprostol for termination of second trimester pregnancy. Design: Interventional Quasi experimental. Setting: Gynae Unit III, Liaquat University Hospital, Hyderabad. Period: 1st March 2006 to 31st August 2006. Methodology: Sixty patients were selected with thirty in each group i.e thirty for oral route (group A) and thirty for vaginal route(group B). The patients included in this study were those having singleton pregnancy with gestational age between 12 to 26 weeks requiring termination of pregnancy. A dose of 100ug to 200ug was used with maximum of 1200ug in each group of patients. Results: The subjects of either group were similar with respect to mean age, height, weight, parity, gestational age and pre induction Bishop Score. The success rate in group A was 94.4% as compared to group B was 86.8%. intra uterine death was the commonest indication in both groups found in 46.7% women of vaginal misoprostol group and 50% women of oral misoprostol group. Surgical evacuation was needed in 36.7% women of oral misoprostol group and 16.7% women of vaginal misoprostol group. Conclusions: The present study shows misoprostol to be effective for mid trimester abortions, both orally and vaginally, the later route is preferable because it requires lesser doses and produces a shorter induction – abortion interval. However safety data are needed to guide the route choice and well designed studies are necessary. 

scholarly journals TERMINATION OF PREGNANCY

2018 ◽  
Vol 25 (06) ◽  
pp. 952-958
Author(s):  
Shakila Yasmin ◽  
Rukhsana Aziz ◽  
Muhammad Hassan ◽  
Mehak Fatima
Keyword(s):  
P Value ◽  
Second Trimester ◽  
Prostaglandin F2 Alpha ◽  
Trimester Pregnancy ◽  
Combined Use ◽  
Second Trimester Pregnancy ◽  
Group A ◽  
The Mean ◽  
Foley’S Catheter ◽  
Group B

Objectives: To compare efficacy of extra-amniotic Foley’s catheter balloon aloneversus combined use of Foley’s catheter balloon and extra-amniotic instillation of prostaglandinF2-alpha in therapeutic termination of second trimester pregnancy. Study Design: Randomizedcontrolled trial. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital,Bahawalpur. Period: Two years. July 2014 to June 2016. Sample Technique: Non-probability,consecutive sampling technique. Patients & Methods: A total of 256 patients, 16 to 38 years ofage with fetal death or missed abortion on ultrasonography in 2nd trimester (14-24 gestationalweeks) of pregnancy were included in the study. Patients with previous uterine surgery, multiplepregnancies and parity>3 were excluded. Then selected patients were placed randomly intotwo groups i.e. Group A (extra-amniotic Foley’s catheter balloon alone) & Group B (Foley’scatheter balloon along with extra-amniotic instillation of prostaglandin F2-alpha), by using lotterymethod. Outcome variables like efficacy i.e. expulsion of fetus within 24 hours of induction, werenoted. Results: The mean age of women in group A was 24.51 ± 4.77 and in group B was 24.29± 4.48 years. The mean gestational age in group A was 21.65 ± 2.01 weeks and in group Bwas 21.28 ± 1.93 weeks. Efficacy was 103 (80.47%) in group A (extra-amniotic Foley’s catheterballoon alone) and 119 (92.97%) in group B (combined use of Foley’s catheter balloon andextra-amniotic instillation of prostaglandin F2-alpha) with p-value of 0.003. Conclusion: Thisstudy concluded that combined use of Foley’s catheter balloon and extra-amniotic instillationof prostaglandin F2-alpha is better and more efficacious than extra-amniotic Foley’s catheterballoon alone in therapeutic termination of second trimester pregnancy.

scholarly journals Misoprostol for Termination of Second Trimester Pregnancy

2015 ◽  
Vol 1 (1) ◽  
pp. 16-19
Author(s):  
Sarada Duwal Shrestha ◽  
Alka Singh ◽  
Laxmi RC ◽  
Benita Pradhan ◽  
Wufei Shah ◽  
...  
Keyword(s):  
Side Effects ◽  
Success Rate ◽  
Congenital Anomalies ◽  
Second Trimester ◽  
Plain Language ◽  
Fetal Demise ◽  
Trimester Pregnancy ◽  
Second Trimester Pregnancy ◽  
Vaginal Misoprostol ◽  
Maternal Side

Introductions: The termination of second trimester pregnancy is challenging due unfavorable cervix. This study evaluate the efficacy and maternal side effects of intravaginal misoprostol for termination of second trimester pregnancy. Methods: During one year period from 15th June 2011 to 14th June 2012, Department of Obstetrics and Gynaecology of Patan Hospital, women admitted for second trimester termination of pregnancy for fetal congenital anomalies and intrauterine fetal demise were studied using the International Federation of Gynaecology and Obstetrics recommended doses of vaginal misoprostol. For congenital anomalies, 400 mcg 3 hourly to a maximum of 5 doses were used. For fetal demise, gestational age of 13-17 weeks received 200 mcg every 6 hourly to a maximum of 4 doses, and 18-26 weeks dose was adjusted to 100 mcg. Main outcome measures included success rate of abortion within 48 hours, induction to delivery interval and maternal side effects. Results: There were 40 patients during study period. Success rate for termination of 2nd trimester pregnancy within 48 hours was 88.8% for congenital anomalies. For fetal demise, success of termination was 90.9% at 13-17 weeks and 100% at 18-26 weeks. Median time from induction to delivery was 26.8 hours for congenital anomalies. For fetal demise, it was 18 hours for 13-17 weeks was and 24 hours at 18 to 26 weeks respectively. Abdominal pain was seen in all doses of misoprostol. Conclusions: Vaginal misoprostol is an effective method for termination of second trimester pregnancy. Plain Language Summary: The study was conducted to see the effectiveness of vaginal misoprostol for termination of second trimester pregnancy. The success rate of termination for congenital abnormality and fetal demise was high. Vaginal misoprostol was an effective method for termination of second trimester pregnancy. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13010 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):16-19

scholarly journals POLA MAKAN DAN PENDAPATAN KELUARGA DENGAN KEJADIAN KEKURANGAN ENERGI KRONIK (KEK) PADA IBU HAMIL TRIMESTER II

2019 ◽  
Vol 13 (1) ◽  
pp. 7-18
Author(s):  
Dewi Taurisiawati Rahayu ◽  
Yona Desni Sagita
Keyword(s):  
Family Income ◽  
Consumption Patterns ◽  
P Value ◽  
Second Trimester ◽  
Energy Deficiency ◽  
Spearman Rank ◽  
Chronic Energy Deficiency ◽  
Trimester Pregnancy ◽  
Second Trimester Pregnancy ◽  
The Relationship

THE INFLUENCE OF FAMILY INCOME ON FOOD CONSUMPTION PATTERNS IN PREVALENCE AND CAUSES OF CHRONIC ENERGY DEFICIENCY AMONG SECOND‐TRIMESTER PREGNANCY. Background: The three main factors of life index are education, health and economy. These factors are closely related to the nutritional status of the community which can be described mainly in the nutritional status of children under five years and pregnant women.Purpose: To know the influence of family income on food consumption patterns in prevalence and causes of chronic energy deficiency among second‐trimester pregnancy. Methods: Analytical research design. The independent variables are diet and family income while the dependent variable is the incidence of chronic energy deficiency. The population of all pregnant women at Grogol Health Center is 50 pregnant women. The sampling technique used was stratified random sampling, the number of samples was 40 respondents. The study was conducted on 30 July-05 August 2018 at the Grogol Kediri Public Health Center in 2018. Data collection instruments used questionnaires, interviews and medlines. Data analysis uses the Spearman Rank test.Results: Statistical tests using Spearman Rank (Rho) correlation, the results of the relationship between eating patterns and the incidence of chronic energy deficiency obtained p value = 0.001 with α <0.05 and c = 0.551 so that the strength of the relationship was moderate, and the results of family income with chronic energy deficiency were obtained p value = 0.002 with α <0.05 and c = 0.465 so that the strength of the relationship is moderate, means there is a relationship between diet and family income with the incidence of chronic energy deficiency in Grogol Kediri Health Center.Conclusion: An unbalanced diet causes an imbalance of nutrients that enter the body and can cause malnutrition. Low income causes people to be unable to buy food in the required amount. So that the high and low income influence the purchasing power of the family towards everyday.Keywords: Family income, food consumption patterns, chronic energy deficiency, second‐trimester pregnancy.  Pendahuluan: Tiga faktor utama indeks hidup yaitu pendidikan,kesehatan dan ekonomi. Faktor-faktor tersebut erat kaitannya dengan status gizi masyarakat yang dapat digambarkan terutama pada status gizi anak balita dan wanita hamilTujuan: Mengetahui ada hubungan antar pola makan dan pendapatan keluarga dengan kekurangan energi kronik pada ibu hamil trimester II.Metode: Desain penelitian analitik.Variabel bebasnya adalah pola makan dan pendapatan keluarga sedangkan variabel terikatnya kejadian kekurangan energi kronik. Populasi semua ibu hamil di Puskesmas Grogol sejumlah 50 ibu hamil. Teknik sampling yang digunakan adalah stratified random sampling, jumlah sampelnya 40 responden. Penelitian dilakukan tanggal 30 Juli-05 Agustus 2018 di Puskesmas Grogol Kediri Tahun 2018.Instrumen pengambilan data menggunakan lembar kuisioner, wawancara dan medline. Analisa data menggunakan uji Spearman Rank.Hasil: Dari hasi uji statistik menggunakan korelasi spearman Rank (Ro),didapatkan hasil hubungan pola makan dengan kejadian kekurangan energi kronik diperoleh p value = 0,001 dengan α < 0.05  dan  c = 0,551 sehingga kekuatan hubungannya sedang, dan hasil pendapatan keluarga dengan kejadian kekurangan energi kronik diperoleh p value = 0,002 dengan α < 0,05 dan c = 0,465 sehingga kekuatan hubungannya sedang, artinya terdapat hubungan antara pola makan dan pendapatan keluarga dengan kejadian kekurangan energi kronik di Puskesmas Grogol Kediri.Simpulan: Pola makan tidak seimbang menyebabkan ketidakseimbangan zat gizi yang masuk kedalam tubuh dan dapat menyebabkan terjadinya kekurangan gizi. Rendahnya pendapatan menyebabkan orang tidak mampu membeli pangan dalam jumlah yang diperlukan. Sehingga tinggi rendahnya pendapatan mempengaruhi daya beli keluarga terhadap bahan pangan sehari-hari.

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