The results of using the combination of letrozole and misoprostol in comparison with laminaria and misoprostol in preparing the cervix for miscarriages under the second trimester of pregnancy

Abstract

Background: Therapeutic abortion in the second trimester pregnancy is the choice treatment in cases with severe anomalies or intrauterine fetal death. It can be done by a number of medical (e.g. misoprostol and letrozole) or mechanical methods (e.g. laminaria). The aim of this study was to compare the efficacy of vaginal misoprostol with and without letrozole and combination of misoprostol and laminaria for preoperative cervical ripening among women with under second trimester abortion. Methods: In this interventional study, 80 pregnant women in the second trimester pregnancy (Gestational age under 20 weeks) were randomly divided in two groups (n=40). One group received vaginal misoprostol in combination with laminaria and oral placebo and other group received vaginal misoprostol in combination with letrozole. Patients regularly examined every 4 hours and in the absence of abortion, vaginal misoprostol repeated after 4 hours. No report of products of conception abortion considered as complete abortion and the patient discharged. Data collected in a cheklist and then analyzed by statistical methods in SPSS version 21. Results: Complete abortion was reported in 70 (87.5%) of all patients which in group letrozole+misoprostol in 34 (85%) and in laminaria+misoprostol was reported in 36 (90%). 6 (15%) Curettage was reported in group letrozole+misoprostl and 4 (10%) in laminaria+misoprostol and the difference were not statistically significant. Conclusions: Results showed that both of combination are effective in the abortion but misoprostol in combination with laminaria is recommended for the induction of second trimester therapeutic abortion.