Abortion Induction in IInd trimester
Authors:
J. Záhumenský 1; B. Zmrhalová 1; K. Maxová 1; K. Hurt 1; D. Stejskal 2; E. Kulovaný 2; M. Dvořák 1; B. Sehnal 1; D. Kolařík 1; O. Šottner 1; D. Driák 1
; M. Halaška 1
Authors‘ workplace:
Gynekologicko-porodnická klinika 1. LF UK, FNB, Praha, přednosta prof. MUDr. M. Halaška, DrSc.
1; Centrum lékařské genetiky a reprodukční medicíny Gennet s. r. o., Praha
2
Published in:
Ceska Gynekol 2008; 73(2): 118-122
Overview
Study aim:
Analysis of the set of women that underwent the termination of pregnancy in IInd trimester at the OBGYN clinic, Teaching Hospital Na Bulovce at interval of years 2006–2007. We appreciated the effect of method and compared with references in the literature.
Type study:
Retrospective descriptive study.
Seatting:
OBGYN clinic of the 1st faculty of Charles University, teaching hospital Na Bulovce, Prague.
Method:
Retrospective analysis of the set of women that underwent termination of pregnancy in the IInd trimester. Data are obtained from medical documentation and statistically processed. The analysis treats with 50 cases, in all of them, cervix was prepared with hydrophile dilators. In 37 cases were subsequently handed up prostaglandins intraamnially, in two cases generally intravenously, in two cases vaginally and 9 pregnancies were finished directly by dilatation and curettage without endeavour about expulsion.
Results:
From 37 women after intraamnial administration of prostaglandins, 35 (94.6%) aborted successfully. Average time from amniocentesis to expulsion was 13 hours 45 minutes, 23 women aborted to 24 hours (62.2%). Undesirable effects were present in 12 cases (32.4%).
Conclusion:
Our record of local intraamnial administration of prostaglandins appears to be effective method. On the other hand, other methods are described in recent literature, which appear to be more efficient and have smaller occurrence of adverse effects.
Key words:
induced abortion, IInd trimester, prostaglandins
Sources
1. Bhattacharjee, N., Ganguly, RP., Saha, SP. Misoprostol for termination of mid-trimester post-Caesarean pregnancy. Aust N Z J Obstet Gynaecol, 2007, 47, p. 23–25.
2. Bhattacharyya, SK., Mukherji, J., Kamilya, GS., et al. Two regimens of vaginal misoprostol in second trimester termination of pregnancy: a prospective randomised trial. Acta Obstet.Gynecol.Scand, 2006, 85, p. 1458–1462.
3. Borgatta, L., Chen, AY., Vragovic, O., et al. A randomized clinical trial of the addition of laminaria to misoprostol and hypertonic saline for second-trimester induction abortion. Contraception, 2005, 72, p. 358–361.
4. Caldeyro-Barcia, R., Sica-Blanco, Y., Poseiro, JJ., et al. A quantitative study of the action of synthetic oxytocin on the pregnant human uterus. J Pharmacol Exp Ther, 1957, 121, p. 18–31.
5. Cowett, AA., Golub, RM., Grobman, WA. Cost-effectiveness of dilation and evacuation versus the induction of labor for second-trimester pregnancy termination. Am J Obstet Gynecol, 2006, 194, p. 768–773.
6. Darney, PD., Sweet, RL. Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation. J Ultrasound Med, 1989, 8, p. 71–75.
7. Fait, T., Calda, P., Zizka, Z., et al. Termination of 128 pregnancies in the 2nd trimester using prostaglandin 15 methyl F2 alpha. Ces Gynekol, 2000, 65, p. 451–455.
8. Fuchs, AR., Fuchs, F., Husslein, P., et al. Oxytocin receptors and human parturition: a dual role for oxytocin in the initiation of labor. Science, 1982, 215, 12-3, p. 1396–1398.
9. Garfield, RE., Hayashi, RH. Appearance of gap junctions in the myometrium of women during labor. Am J Obstet Gynecol, 1981, 140, 1-6, p. 254–260.
10. Garfield, RE., Hayashi, RH., Harper, MJ. In vitro studies on the control of human myometrial gap junctions. Int J Gynaecol Obstet, 1987, 25, p. 241–248.
11. Givens, VM., Lipscomb, GH. Retained fetal parts after elective second-trimester dilation and evacuation. Obstet Gynecol, 2007, 109, p. 526–527.
12. Hidar, S., Jerbi, M., Khairi, H. Association of intravenous oxytocin to vaginal misoprostol for mid trimester labor induction. Am J Obstet Gynecol, 2006, 195, p. 332–333.
13. Husslein, P., Fuchs, AR., Fuchs, F. Oxytocin and the initiation of human parturition. I. Prostaglandin release during induction of labor by oxytocin. Am J Obstet Gynecol, 1981, 141, 15-11, p. 688–693.
14. Jackson, JE., Grobman, WA., Haney, E., et al. Mid-trimester dilation and evacuation with laminaria does not increase the risk for severe subsequent pregnancy complications. Int J Gynaecol Obstet, 2007, 96, p. 12–15.
15. Kalish, RB., Chasen, ST., Rosenzweig, LB., et al. Impact of midtrimester dilation and evacuation on subsequent pregnancy outcome. Am J Obstet Gynecol, 2002, 187, p. 882–885.
16. Krofta, L., Calda, P., Zizka, Z., et al. Termination of pregnancy in the 2nd trimester using intra-amniotic administration of prostaglandins. Ces Gynek, 1998, 63, p. 414–417.
17. Macisaac, L., Darney, P. Early surgical abortion: an alternative to and backup for medical abortion. Am J Obstet Gynecol, 2000, 183, p. S76–S83.
18. Nilas, L., Glavind-Kristensen, M., Vejborg, T., et al. One or two day mifepristone-misoprostol interval for second trimester abortion. Acta Obstet Gynecol Scand, 2007, 86, p. 1117–1121.
19. Nor Azlin, MI., Abdullah, HS., Zainul Rashid, MR., et al. Misoprostol (alone) in second trimester terminations of pregnancy: as effective as Gemeprost? J Obstet Gynaecol, 2006, 26, p. 546–549.
20. Owen, J., Hauth, JC. Concentrated oxytocin plus low-dose prostaglandin E2 compared with prostaglandin E2 vaginal suppositories for second-trimester pregnancy termination. Obstet Gynecol, 1996, 88, p. 110–113.
21. Owen, J., Hauth, JC. Vaginal misoprostol vs. concentrated oxytocin plus low-dose prostaglandin E2 for second trimester pregnancy termination. J Matern Fetal Med, 1999, 8, p. 48–50.
22. Owen, J., Hauth, JC., Winkler, CL., et al. Midtrimester pregnancy termination: a randomized trial of prostaglandin E2 versus concentrated oxytocin. Am J Obstet Gynecol, 1992, 167, p. 1112–1116.
23. Ramsey, PS., Savage, K., Lincoln, T., et al. Vaginal misoprostol versus concentrated oxytocin and vaginal PGE2 for second-trimester labor induction. Obstet Gynecol, 2004, 104, p. 138–145.
24. Rose, SB., Shand, C., Simmons, A. Mifepristone- and misoprostol-induced mid-trimester termination of pregnancy: a review of 272 cases. Aust NZ J Obstet Gynaecol, 2006, 46, p. 479–485.
25. Saha, S., Bal, R., Ghosh, S., et al. Medical abortion in late second trimester – a comparative study with misoprostol through vaginal versus oral followed by vaginal route. J Indian Med Assoc, 2006, 104, p. 81–82, 84.
26. Su, LL., Biswas, A., Choolani, M., et al. A prospective, randomized comparison of vaginal misoprostol versus intra-amniotic prostaglandins for midtrimester termination of pregnancy. Am J Obstet Gynecol, 2005, 193, p. 1410–1414.
27. Winkler, CL., Gray, SE., Hauth, JC., et al. Mid-second-trimester labor induction: concentrated oxytocin compared with prostaglandin E2 vaginal suppositories. Obstet Gynecol, 1991, 77, p. 297–300.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
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