Effect of Misoprostol in Third Trimester of Pregnancy- A Multi-Center Study in Bangladesh

Abstract

Background: Misoprostol is an analogue of prostaglandin (PGE1) and the first registered PGN used for the treatment of peptic ulcer disease. Misoprostol should not be used in pregnant women but it can be used in termination of intrauterine fetal death (IUFD). It has been used for the induction of abortion in the first and second trimester of pregnancy. Misoprostol has already been proved to be effective and efficient for second trimester since 1987. There is insufficient information available from clinical trials to support their use to induce labor in third trimester of pregnancy. Aim of the study: The aim of this study was to describe the effect of misoprostol in third trimester of pregnancy. Methods: This retrospective study was carried out in two large hospitals in Dhaka city, which is the capital of a South Asian country, Bangladesh. The record of the studied subject was taken from the Department of Obstetrics and Gynecology of Alpha Hospital and the maternity ward of Beta Hospital from June 2018 to August 2019. The actual names of the two hospitals are pseudonym for privacy. A detailed history of each patient was taken and physical and obstetric examination were done. In total 52 patients were investigated and data were analyzed by SPSS version 23.0. Results: In this study, the primi gravida response time was found as the highest. On an average 20.34 hours was needed for the primi gravida category. In single, 2 and multi-parity cases the average pain response times were found as 16.3125, 10.3375 and 14 hours respectively. In Primi, 2nd, 3rd and 5th gravida cases the average delivery times were found 13.0714, 12.5938, 9.0769 and 3 hours respectively. Against single, two and three doses of misoprostol, the average pain response times were found 7.6875, 11.5375 and 19.25 hours respectively. Conclusion: In this study, it had been found that, most of the patient of IUFD was ‘primigravid’ (30.8%) of total respondents having complication with medical and endocrinal disease. Pre- eclampsia is more common in prim gravid than multi. There is history of thyroid dysfunction. In some cases, now a day, GDM is the cause behind IUFD.