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.

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 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.

Simultaneous Administration Compared With a 24-Hour Mifepristone–Misoprostol Interval in Second-Trimester Abortion

2016 ◽  
Vol 128 (5) ◽  
pp. 1077-1083 ◽  
Author(s):  
Dina Fatima Abbas ◽  
Jennifer Blum ◽  
Nguyen Thi Nhu Ngoc ◽  
Nguyen Thi Bach Nga ◽  
Huynh Thi Kim Chi ◽  
...  
Keyword(s):  
Simultaneous Administration ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Second Trimester Abortion

scholarly journals A Comparative study of Extra-Amniotic Instillation of Ethacridine with Tablet Dinoprostone (PGE2) in Second Trimester Abortion Versus Ethacridine Alone

2013 ◽  
Vol 7 (1) ◽  
pp. 25-27
Author(s):  
Sandeep Kour ◽  
G Kour
Keyword(s):  
Success Rate ◽  
Combination Group ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Obstetrics And Gynaecology ◽  
Crushed Tablet ◽  
Ethacridine Lactate ◽  
Second Trimester Abortion ◽  
The Mean ◽  
Foley’S Catheter

Aims: To study the efficacy of combination of extra-amniotic instillation of ethacridine with tablets Dinoprostone (PGE2) in second trimester abortion as compared to ethacridine alone. Methods: One hundred patients undergoing second trimester abortion were divided into two groups. Fifty patients received extra-amniotic ethacridine lactate 150 ml through Foley’s catheter (Ethacridine group) and the other 50 patients received 150 ml extra-amniotic ethacridine lactate mixed with a 0.5 mg of a crushed tablet of Dinoprostone through Foley’s catheter (Combination group). Both the groups were compared in respect to instillation-abortion interval, completeness of abortion and success rate. Results: The mean age, multiparity parity, and gestational age were comparable in both the groups. The instillation- abortion interval was significantly shorter in combination group as compared to ethacridine group (16.4±7.1 vs. 29.9 ±13.9 hours, p<0.001). Two patients in combination group had instillation abortion interval more than 48 hours as compared to 16 patients in ethacridine group(p<0.0005). Forty one patients (82%) in combination group had complete abortion as compared to 37 (74%) patients in ethacridine group. The success rate was 48/50(96%) in combination group as compared to 45/50 (90%) in ethacridine group. Conclusions: Addition of a 0.5 mg of crushed tablet of Dinoprostone in extra-amniotically instilled ethacridine lactate reduced the instillation-abortion interval significantly, increased the chances of complete abortion and increased the success rate. Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 25-27 DOI: http://dx.doi.org/10.3126/njog.v7i1.8831

scholarly journals COMPARISON OF PERINATAL OUTCOME IN TWIN PREGNANCY WITH AND WITHOUT CERVICAL CERCLAGE

2020 ◽  
pp. 48-52
Author(s):  
Kalpana Damor ◽  
Sandhaya Choudhary ◽  
Himanshi Gangwal
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Twin Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
The Mean

Background: The incidence of multifetal pregnancies has registered increase globally. Babies born from multiplebirth pregnancies are much more likely to result in premature birth than those from single pregnancies. Knowledge of role of cervical cerclage in preventing preterm birth especially in twin pregnancy can be helpful to prevent complication related to preterm birth and ultimately of low birth weight babies. Methods: Depending upon who opt for the procedure 100 patients were divided equally into two groups: 1)Twin pregnancy with cervical cerclage; 2)Twin pregnancy without cervical cerclage. We measured maternal outcomes which include time for which patient required to be hospitalized, maternal pyrexia, cervical or bladder injury and other maternal morbidity and perinatal outcomes which include preterm delivery (delivery before 37 completed weeks), low birth weight (birth weight ≤2000 g), IUGR, perinatal mortality, indicators of perinatal morbidity (APGAR scores and neonatal unit admission), stillbirth, second trimester loss and presence of congenital malformations. Results: In Study group 22% delivered before 34 weeks of gestation, 46% delivered between 34 and 37 weeks of gestation, 32% delivered after 37 weeks of gestation compared to 44%, 48% and 8% respectively in Control group. The mean gestational age at delivery was 35.3 weeks in Study group and was 33.2 weeks in Control group. In study group 47% neonates had birth weight less than 2Kg and in Control group 69% neonates had birth weight less than 2Kg. In Study group 95% had Apgar score more than 6 whereas in Control group 86% had APGAR score more than 6. The mean APGAR for Study group was 8.5 and for Control group was 7.5. 45% neonates had complications in Study group whereas 67% neonates in Control group. Overall Low birth weight was most common complications in both the groups. Respiratory distress was more common in Control group. Conclusions: In spite of close vigilance, preterm birth in twin gestation is common and unpredictable. It is difficult to predict those who may require cervical cerclage although all multiple pregnancies are at high risk. Cerclage should be considered an option for patients with twin pregnancies in the second trimester to prolong the duration of gestation as close to term as possible.

scholarly journals Prophylactic uterine artery embolization in second-trimester pregnancy termination with complete placenta previa

2018 ◽  
Vol 47 (1) ◽  
pp. 345-352
Author(s):  
Yinfeng Wang ◽  
Changchang Hu ◽  
Ningpin Pan ◽  
Chaolu Chen ◽  
Ruijin Wu
Keyword(s):  
Hospital Stay ◽  
Pregnancy Termination ◽  
Placenta Previa ◽  
Control Group ◽  
Second Trimester ◽  
Artery Embolization ◽  
Trimester Abortion ◽  
Trimester Pregnancy ◽  
Second Trimester Pregnancy ◽  
Second Trimester Abortion

Objective This study was performed to assess whether prophylactic uterine artery embolization (UAE) is beneficial for second-trimester abortion with complete placenta previa (CPP). Methods Patients with CPP who underwent second-trimester pregnancy termination by labor induction with or without UAE from January 2010 to January 2018 were retrospectively reviewed. In total, 25 patients were eligible for analysis. The primary outcomes were the abortion success rate and bleeding volume, and the secondary outcomes were the induction-to-abortion time, length of hospital stay, and complications. Results CPP occurred in all 25 patients. Fifteen patients underwent prophylactic UAE (UAE group) and 10 did not (control group). Abortion was successful in 13 of 15 (86.7%) women in the UAE group and in 9 of 10 (90.0%) women in the control group. There was no significant difference in the bleeding volume or induction-to-abortion time between the two groups. The hospital stay was longer and pyrexia was more common in the UAE than control group. Conclusion Prophylactic UAE did not markedly improve the outcomes of second-trimester abortion in patients with CPP. Conversely, it may increase the risk of complications and prolong the hospital stay.

Environmental Exposures in the Etiology of Abortion: Placental Toxic and Trace Element Levels

2020 ◽  
Vol 224 (06) ◽  
pp. 339-347
Author(s):  
Emre Baser ◽  
Demet Aydogan kırmızı ◽  
Vugar Ali Turksoy ◽  
Taylan Onat ◽  
Melike Demir Çaltekin ◽  
...  
Keyword(s):  
Trace Elements ◽  
Trace Element ◽  
Odds Ratio ◽  
Toxic Elements ◽  
Independent Predictor ◽  
First Trimester ◽  
Control Group ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Second Trimester Abortion

Abstract Purpose Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion. Methods The patient group consisted of 30 women with missed abortion. The control group comprised 60 healthy term and singleton pregnant women who gave birth. Placental samples were obtained from the patients and the healthy controls, and the concentrations of placental elements were measured using inductively coupled plasma mass spectrometry. Results In the abortion group, placental arsenic, cadmium, mercury, lead, antimony, tin, cobalt, manganese, and selenium levels were significantly higher than those of the control group (p<0.05). Antimony was determined as an independent predictor with an odds ratio of 6.1 in toxic elements (p=0.025), and selenium was determined as an independent predictor with an odds ratio of 2.3 in trace elements (p=0.015). Conclusion The changes in trace element and toxic element levels, especially an increase in antimony and selenium, in placental tissue due to environmental exposure may play an important role in second-trimester abortion.

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