A Rare Presentation of Transvaginal Septum in Second Trimester Abortion: A Case Report

Background: A transvaginal septum occurs if these two tissue groups do not fuse properly by 5 months of embryonic life. The recommended mode of safe termination for second trimester pregnancy with a diagnosis of high transverse vaginal septum is cervical preparation followed by septostomy and dilation and curettage. Case Summary: A 28 years-old gravida-II Para-I (alive by CS for unknown indication) presented at gestational age 15 weeks plus 6. Hysterotomy was done for an indication of septic inevitable missed second trimester abortion plus presumptive diagnosis of high vaginal septum. Conclusion: According to the case reports that has been reported, the recommended management for safe termination of second trimester pregnancy with a diagnosis of transvaginal septum is good cervical preparation followed by septostomy and dilation and curettage (D&E).

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Medical and Surgical Abortion in the Second Trimester of Pregnancy

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v10i1.13189 ◽

2015 ◽

Vol 10 (1) ◽

pp. 25-29

Author(s):

A Karki ◽

G Dangal ◽

HK Pradhan ◽

R Shrestha ◽

K Bhattachan

Keyword(s):

Good Method ◽

Median Number ◽

Second Trimester ◽

Cervical Dilation ◽

Trimester Abortion ◽

Second Trimester Pregnancy ◽

Second Trimester Abortion ◽

Cervical Preparation ◽

Medical Induction ◽

Surgical Abortion

Aims: This study was done to know the demographic profile of women undergoing second trimester abortion at Kathmandu Model Hospital. The aim was to see the success rate of combination of mifeprostone and misoprostol for the medical induction and misoprostol alone for the cervical dilation in case of surgical evacuation.Methods: A retrospective study was done by looking at the profiles of 540 clients on whom second trimester abortion was performed during the period of October 2010 to October 2014. Twenty-nine women underwent dilatation and evacuation (D&E) with misoprostol cervical priming, and 510 underwent medical induction with mifeprostone and misoprostol whereas one client absconded. Furthermore, the reasons for seeking second trimester abortion were also investigated.Results: It can be seen that the age of women undergoing second trimester abortion at Kathmandu Model Hospital was greatest (33.33%) for the age group of 26-30 years. Most women were illiterate (31.67%) and a majority of the women were housewives (89.81%). A greater proportion of the women had never undergone abortion. Mental cause appeared to be the major reason for abortion constituting 82.04%. Success was 90.58%, expulsion with total five doses of misoprostol. The median induction to abortion time was 4-7 hours. The expulsion hours increased as the gestational age increased. The median number of dose of misoprostol required was two for medical induction and three for surgical abortion.Conclusions: Mifeprostone and misoprostol, as combination was a good method for the medical induction of second trimester pregnancy and misoprostol alone for the cervical preparation in surgical evacuation was promising.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180455 ◽

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.

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

Journal of International Medical Research ◽

10.1177/0300060518801455 ◽

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.

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Transverse vaginal septum identified in a patient requesting second trimester abortion: a case report

Contraception ◽

10.1016/j.contraception.2017.07.002 ◽

2017 ◽

Vol 96 (5) ◽

pp. 378-379 ◽

Cited By ~ 1

Author(s):

Jennifer A. Pitotti ◽

Veronica I. Alaniz ◽

Stephanie Teal ◽

Kristina Tocce

Keyword(s):

Case Report ◽

Second Trimester ◽

Trimester Abortion ◽

Vaginal Septum ◽

Transverse Vaginal Septum ◽

Second Trimester Abortion

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Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/s1090-798x(08)79112-4 ◽

2008 ◽

Vol 2008 ◽

pp. 206-207

Author(s):

L.P. Shulman

Keyword(s):

Second Trimester ◽

Trimester Pregnancy ◽

Second Trimester Pregnancy ◽

Cervical Preparation

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Buccal misoprostol as cervical preparation for second trimester pregnancy termination

Contraception ◽

10.1016/s0010-7824(02)00306-2 ◽

2002 ◽

Vol 65 (6) ◽

pp. 415-418 ◽

Cited By ~ 37

Author(s):

Catherine S. Todd ◽

Maria Soler ◽

Laura Castleman ◽

M.Katherine Rogers ◽

Paul D. Blumenthal

Keyword(s):

Pregnancy Termination ◽

Second Trimester ◽

Trimester Pregnancy ◽

Second Trimester Pregnancy ◽

Cervical Preparation

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Cervical Preparation and Dilation Prior to Second Trimester Abortion [8G]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000558708.98908.59 ◽

2019 ◽

Vol 133 (1) ◽

pp. 75S-76S

Author(s):

Nicole I. Economou ◽

Ugonna Ihenacho ◽

Victoria Cortessis ◽

Melissa Faith Q. Natavio

Keyword(s):

Second Trimester ◽

Trimester Abortion ◽

Second Trimester Abortion ◽

Cervical Preparation

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Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy

Contraception ◽

10.1016/j.contraception.2005.10.004 ◽

2006 ◽

Vol 73 (4) ◽

pp. 420-430 ◽

Cited By ~ 44

Author(s):

Ashlesha Patel ◽

Elizabeth Talmont ◽

Johanna Morfesis ◽

Murray Pelta ◽

Mary Gatter ◽

...

Keyword(s):

Second Trimester ◽

Trimester Pregnancy ◽

Second Trimester Pregnancy ◽

Cervical Preparation

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Comparison of the Foley catheter and dinoprostone pessary for cervical preparation before second trimester abortion

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1989.tb06308.x ◽

1989 ◽

Vol 96 (12) ◽

pp. 1432-1434 ◽

Cited By ~ 9

Author(s):

G. A. HACKETT ◽

P. REGINALD ◽

D. PAINTIN

Keyword(s):

Foley Catheter ◽

Second Trimester ◽

Trimester Abortion ◽

Second Trimester Abortion ◽

Cervical Preparation

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Comparative study between intravaginal misoprostol and extra-amniotic instillation of ethacridine lactacte for second trimester abortion

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172354 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2575

Author(s):

Suryaprakash Jagdevappa Karande ◽

Meena Shantanu Gunjotikar

Keyword(s):

Side Effects ◽

Pregnancy Termination ◽

First Trimester ◽

Second Trimester ◽

Trimester Abortion ◽

Ethacridine Lactate ◽

Second Trimester Pregnancy ◽

Group A ◽

Second Trimester Abortion ◽

Group B

Background: The methods of terminating pregnancy in the first trimester are simple, safe and effective. Factors like lack of knowledge about availability of MTP services, ignorance, denial of pregnancy, fear of society may account for decrease in number of first trimester abortions. The aims of the present study were to compare the efficacy, induction abortion interval and side effects of intravaginal misoprostol with extra amniotic installation of ethacridine lactate for second trimester abortion.Methods: 60 women coming to MTP clinics requesting second trimester pregnancy termination between 12 to 20 weeks were selected. Detail history and examination was carried out in each patient. They divided into two groups, Group A (30) intravaginal misoprostol 400 initially followed by 400 micrograns every 6 hourly if required. Group B (30) extra-amniotic 0.1% ethacridine lactate 150 cc.Results: In Group A success rate was 100% while in Group B it was 76.66%, which is highly statistically significant (P< 0.01). Mean I – A interval in Group A was 14.58+5.25 hours was highly significantly less than in Group B, it was 33.91 + 3.97 hours (p<0.0001). In Group A complete abortion has occurred in 28 cases (93.33%) and in Group B in 12 cases (52.17%).Conclusions: We conclude that, as compared to extra-amniotic instillation of ethacridinelactate intravaginal misoprostol is the preferred regimen in second trimester abortion because of its high efficacy, shorter induction abortion interval, high incidence of completeness of abortion, low incidence of side effects and better tolerance by the patient.

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