scholarly journals INTRA-VAGINAL MISOPROSTOL ALONE VS MISOPROSTOL IN COMBINATION WITH INTRA-CERVICAL FOLEY’S CATHETER FOR SECOND TRIMESTER ABORTION: A COMPARATIVE STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3241-3243
Author(s):  
Megha bandil
Keyword(s):  
Success Rate ◽  
Pregnancy Termination ◽  
Effective Means ◽  
Foley Catheter ◽  
Second Trimester ◽  
Standard Regimen ◽  
Trimester Abortion ◽  
Percent Success ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter

Pregnancy termination in the second trimester is riskier than in the first. The primary objective is to create a more effective means of termination while also reducing induction time. To compare the efficacy, safety, and acceptability of intra-cervical foley's catheter with vaginal misoprostol versus vaginal misoprostol for second-trimester pregnancy termination. This clinical study involved 400 pregnant women who were scheduled to have their pregnancy terminated between 13 and 22 weeks of pregnancy for any reason. The enrolled women were divided into two categories: Category I (Misoprostol category): intra-cervical Foley’s catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses; Category II (Combined category): intra-cervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses 4 hourly intra-vaginal injections were employed. Misoprostol was retained in the posterior fornix, and the dose was repeated every 4 hours until the catheter was removed, or until a maximum of five doses had been administered. The mean induction to abortion interval in the misoprostol category was 15.38 + 1.25 hours and 8.25 + 2.25 hours in the combination category, which was statistically significant (p= 0.001). The misoprostol category had a 94 percent success rate, while the combined category had a 97 percent success rate. The use of a combined intra-cervical foley's catheter and vaginal misoprostol to end a pregnancy in the second trimester is a novel, safe, effective, and acceptable procedure.

scholarly journals Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion

2018 ◽  
Vol 7 (11) ◽  
pp. 4545
Author(s):  
Michelle N. Fonseca ◽  
Vernica Sah
Keyword(s):  
Side Effects ◽  
Foley Catheter ◽  
Medical Abortion ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Sequential Administration ◽  
Group A ◽  
Low Incidence ◽  
Vaginal Misoprostol ◽  
Group B

Background: Abortions are one of the most commonly performed procedures in gynaecological departments worldwide. They are still a major problem in developing countries contributing to a significant percentage of maternal morbidity and mortality. The main objective of this study is to compare the efficacy, side effects and acceptability of intracervical Foley and oral Mifepristone both followed with sequential administration of vaginal misoprostol for second trimester medical abortion.Methods: This was a prospective randomized trial of 36 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation between 12 to 20 completed weeks. Intracervical Foley catheter with administration of misoprostol (200µg) vaginally was done for Group A. Mifepristone 200mg was administered on day one followed by misoprostol (200µg) vaginally, 48 hours later, to Group B. Both groups received misoprostol (200µg) vaginally at 4 hourly intervals. Completeness of abortion was assessed, and surgical evacuation was performed, if abortion was found to be incomplete.Results: The two groups were comparable with respect to age, parity and gestational age. 83-89% of the women in both the groups had complete abortion. The mean induction abortion interval was 20.11 hours in Group A and 54.77 hours in Group B, which was statistically significant. Side effect profile was comparable in both groups however the intensity and the duration of persistence of pain was greater among patients from Group A.Conclusions: Authors conclude that medical abortions with both methods were found to be safe, effective, inexpensive and acceptable methods. Whereas a shorter induction abortion interval was observed in the Foley induction group, induction with mifepristone was the preferred regimen in second trimester abortion because of its high efficacy, low incidence of side effects, better tolerance by the patients and due to lower dose of misoprostol required following mifepristone administration.

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 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 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

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.

DEGLOVING BOWEL INJURY FOLLOWING SECOND TRIMESTER PREGNANCY TERMINATION IN THE ERA OF MODERN OBSTETRICS: A CASE REPORT

2021 ◽  
pp. 5-6
Author(s):  
Shree Bharathi ◽  
Deepthi Nayak ◽  
Vinodhini Kadir ◽  
Niveditha Jha ◽  
Haritha Sagili
Keyword(s):  
Pregnancy Termination ◽  
Rare Complication ◽  
Medical Abortion ◽  
Bowel Injury ◽  
Second Trimester ◽  
Fetal Head ◽  
Trimester Abortion ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Degloving Injury

Degloving injury to the bowel following uterine instrumentation is a rare complication of second trimester abortion. Unsafe abortion practices can lead to such complications adding on the maternal mortality and morbidity. Here we present a case of 19-year-old unmarried girl who had undergone medical abortion and sustained decapitation of the fetal head during breech delivery which necessitated instrumentation for its retrieval leading to perforation and degloving bowel injury

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