Mid-trimester Termination Of Pregnancy Research Articles

Mid-Trimester Termination of Pregnancy by Vaginal Misoprostol in Missed Abortion

The use of vaginal misoprostol, a prostaglandin analogue is an effective and safe management option for missed abortion. This study evaluated a low-dose (200 microgram) vaginally administered misoprostol four hourly to assess the success rate of medical management in mid-trimester missed abortion. A total of fifty patients with missed abortion, who had agreed to undergo medical treatment with vaginal misoprostol were enrolled. They were apparently healthy, between 18-40 years of age, less than 20 weeks of gestation, and had missed abortions verified by ultrasonogram report. All study women with missed abortion; misoprostol tablet (200 microgram) was applied in the posterior fornix of the vagina every four hourly. Complete abortion was confirmed by passage of products of conception and by clinical finding at the pelvic examination along with ultrasonogram report. In this study, we have demonstrated that 92% of patients were successfully treated by vaginal misoprostol. Only one patient needed oxytocin drip and three patients were managed by evacuation and curettage. This study showed that vaginal misoprostol is safe and effective method of treatment for mid-trimester missed abortion.

Misoprostol and mid trimester termination of pregnancy in patients with two previous scars and more at Elwiya Maternity Teaching Hospital

Resumo Objetivos: determinar a eficiência e segurança de três regimes de misoprostol para interrupção da gravidez no segundo trimestre em indivíduos com duas ou mais cicatrizes de cesariana. Métodos: um estudo transversal incluiu 100 gestantes entre 13ª e 26ª semanas de gestação com duas cesarianas (CEs) anteriores que foram agendadas para interrupção da gravidez com uso de misoprostol. Os pacientes foram convenientemente designados para regimes de 100 µg/3 horas, 200 µg/3 horas ou 400 µg/3 horas. O desfecho primário foi o tempo para o aborto, os desfechos secundários foram efeitos colaterais e complicações. Resultados: foi encontrada associação significativa entre o número de cesáreas anteriores e o maior tempo até o aborto (p=0,01). Foi identificada associação altamente significativa entre idade gestacional mais precoce e maior tempo para abortar (p<0,001). Menores efeitos colaterais e complicações foram associados com 200 µg de misoprostol a cada 3 horas (p<0,001). O aborto incompleto foi a complicação mais frequente registrada para as doses sucessivas de misoprostol. Conclusões: o misoprostol é um medicamento eficaz em doses baixas para interrupção da gravidez em mulheres com duas ou mais cesarianas anteriores. Porém, sua segurança necessita de monitoramento do paciente no hospital para diminuir a morbimortalidade por trás de seu uso.

A PROSPECTIVE STUDY TO COMPARE COMBINED USE OF INTRAVAGINAL MISOPROSTOL AND INTRACERVICAL FOLEY CATHETER VERSUS INTRAVAGINAL MISOPROSTOL ALONE FOR TERMINATION OF MID-TRIMESTER PREGNANCY IN DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY SMS MEDICAL COLLEGE, JAIPUR

Aims and Objectives: The aims and objectives of the study are to compare the mean induction to abortion interval and efficacy of intra-vaginal misoprostol alone versus combined use of intravaginal misoprostol and intracervical Foley catheter in termination of mid-trimester pregnancy. Methods: This was prospective, comparative study conducted during March 2021 to April 2022 at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. The study included sample size of 60 cases (30 cases in each group). 60 cases were randomly allocated to either intravaginal misoprostol alone (Group A) or combined use of intravaginal misoprostol and Foley catheter (Group B) for termination of mid-trimester pregnancy. The study included all pregnant females between 14 and 20 weeks of gestation who were admitted for termination of pregnancy. Results: Mean induction to abortion interval±standard deviation for Group A was 20.79±2.01 h and for Group B, it was 17.29±3.58 h. Mean dose of tablet misoprostol required for Group A±standard deviation was 1453.3±267.47 mcg and for Group B, it was 1053.33±267.47 mcg. Conclusion: In this study, we found that with the combined use of intravaginal misoprostol and intracervical Foley catheter, there was a significant reduction in duration of induction to abortion, total dose misoprostol required, and hospital stay than in intravagnial misoprostol alone in termination of mid-trimester pregnancy.

Can transvaginal cervical length and cervical strain elastography predict mid-trimester medical induction to abortion intervals?

Objective Mid-trimester pregnancy terminations are becoming an increasingly common practice in obstetrics. Accurate prediction of delay from induction to abortion may help in planning the optimal time for the medical induction process and optimising the use of healthcare services. Therefore, we aimed to assess whether the transvaginal cervical length and cervical elastography can predict the time interval from medical induction to abortion in cases of medically indicated mid-trimester pregnancy termination. Materials and methods We performed a prospective observational pilot study between January 2022 and October 2022 in patients who have undergone medically indicated mid-trimester pregnancy termination with a non-dilated cervix for foetal morphological, chromosomal abnormalities or preterm premature rupture of membranes. Cervical length (CL) and cervical strain ratio (CSR) were measured by transvaginal sonography. The predictive value of CL and CSR on the induction to abortion interval was calculated after medical induction with misoprostol. Results Fifty-three eligible pregnant women were evaluated. The mean gestational age at abortion was 17.61 ± 2.81 weeks. The mean time interval from induction to abortion was 31.72 ± 16.57 h. In multivariate linear regression analysis, CL and the history of previous vaginal delivery were the significant independent predictors of the induction to abortion interval (all p < 0.01), with no additional significant contribution from CSR. Conclusion Transvaginal CSR is unlikely to be useful in the prediction of induction to abortion interval in the mid-trimester medically indicated termination of pregnancy. SHORT CONDENSATION Transvaginal cervical length is the significant independent predictor of the induction to abortion interval in the mid-trimester medically indicated termination of pregnancy with no additional significant contribution from cervical strain ratio.

A Comparative Study of the Effectiveness of Intravaginal Misoprostol Alone and Combined Use of Intravaginal Misoprostol and Intracervical Foley's Catheter for Termination of Mid Trimester Pregnancy in Women with Previous Ceserean Section

A Comparative Study of the Effectiveness of Intravaginal Misoprostol Alone and Combined Use of Intravaginal Misoprostol and Intracervical Foley's Catheter for Termination of Mid Trimester Pregnancy in Women with Previous Ceserean Section

Extra-Amniotic Infusion of Corticosteroids versus Normal Saline for Cervical Ripening and Shortening of 1st Stage of Labour in Mid Trimester Termination of Pregnancy

Background: Pregnancy termination is still a big challenge for Obstetrician specifically in case when the Cervix is not ripped. Recently it was shown that the extra amniotic infusion of corticosteroids is superior in terms of mean duration of first stage of labour and frequency of cervical Ripening to the conventional practice of extra-amniotic infusion of normal saline. However, the limited data and lack of local research material necessitated this study. Objective: The objective of this study was to compare outcome of extra-amniotic infusion of corticosteroids versus normal saline for cervical ripening and mean duration of 1st stage of labour in mid trimester termination of pregnancy. Material &amp; Methods: It was a randomized controlled trial. Research was conducted at Department of Obstetrics &amp; Gynecology Rai Medical College Teaching Hospital, Sargodha from 10/01/2022 to 09/06/2022. This study involved 100 pregnant women aged between 18-40 years undergoing termination of pregnancy between 14-28 weeks of gestation (as per dating scan). These patients were randomly allocated into two groups. Patients in Group-A were given extra-amniotic infusion of corticosteroids while those in Group-B received extra-amniotic infusion of normal saline. Outcome variables were mean duration of first stage of labor and frequency of cervical ripening which was noted and compared between the groups. A written informed consent was taken from each patient Results: The mean duration of first stage of labor was significantly shorter in women receiving extra-amniotic infusion of steroids as compared to normal saline (178.94±34.19 vs. 237.20±24.84 minutes; p-value&lt;0.001). The frequency of cervical ripening was significantly higher in women receiving extra-amniotic infusion of steroids as compared to normal saline (96.0% vs. 72.0%; p-value=0.001). Conclusion: Extra-amniotic infusion of corticosteroids was found superior to conventional practice of normal saline in terms of significantly higher frequency of cervical ripening and significantly shorter mean duration of 1st stage of labor which is desirable in women undergoing mid-trimester termination of pregnancy and advocates preferred use of extra-amniotic infusion of corticosteroids in future obstetric practice Keywords: Mid-Trimester Abortion, Cervical Ripening, Steroids, Extra-amniotic Infusion

7292 Laparoscopic Foetal Extraction and Repair of Uterine Rupture at 20 Weeks of Gestation

<h3>Study Objective</h3> To demonstrate the viability of laparoscopic intervention for uterine rupture in selected cases. <h3>Design</h3> Case report. <h3>Setting</h3> Hospital with ICU facility. <h3>Patients or Participants</h3> A 28-year-old G4 P2 A1 with uterine rupture at 20 weeks looking to preserve her fertility. <h3>Interventions</h3> Laparoscopic intervention instead of laparotomy for a ruptured uterus. <h3>Measurements and Main Results</h3> Termination of pregnancy is a common medical procedure performed in the second trimester when the foetus has multiple anomalies. Termination of mid-trimester pregnancy constitutes about 10 to 15% of all abortions worldwide. We demonstrate a laparoscopic approach for foetal extraction which will definitely benefit the patient especially when she is planning to have another baby. <h3>Conclusion</h3> Uterine rupture is a rare complication following induction of labour for the termination of pregnancy with previous surgeries. It is usually associated with severe lower abdominal pain and sudden cessation of contractions along with haemorrhagic shock caused by intra- abdominal haemorrhage. Laparotomy is the standard procedure to repair uterine rent or to perform a hysterectomy. Here, we present a case of uterine rupture in a patient at 20 weeks of gestation who underwent termination of pregnancy by induction of labour for multiple fetal anomalies. Patient was successfully managed by laparoscopy. It suggests that laparoscopy can be an effective approach in the treatment of uterine rupture for hemodynamically stable patients.

The method for termination of mid-trimester pregnancy with placenta previa: A case study.

Background:Prenatal bleeding is very dangerous for pregnant women with placenta previa during termination of pregnancy in the mid-trimester. Traditionally, cesarean section or hysterectomy is used to stop bleeding. This study aims to investigate the method for termination of mid-trimester pregnancy with placenta previa, especially emergency uterine artery embolization (UAE) combined with cervical double balloon (CDB).Methods:A retrospective study was conducted based on 261 cases of mid-pregnancy termination in our hospital, where 34 cases with placenta previa were set as the observation group, and the remaining 227 cases were set as control group. At first, the termination method of Mifepristone combined with Misoprostol/Ethacridine Lactate was adopted. If the volume of prenatal bleeding was up to 400 mL, emergency uterine artery embolization (UAE) was implemented to stop bleeding, then cervical double balloon (CDB) was used to promote cervical ripening. Receiver operating characteristic (ROC) curves analysis was performed to assess the accuracy in predicting the length of placental edge crossed the cervical os for prenatal bleeding.Results:The number of gravidity/parities, the rate of cesarean section, the medical cost, the rate of previous cesarean section were all higher in the observation group than in the control group (P < .05). The volume of prenatal hemorrhage, postpartum hemorrhage, the rate of puerperal morbidity, emergency UAE rate and ICU rate were higher in the observation group than in the control group (P < .05). There were 4 cases showing prenatal hemorrhage up to 400 mL and undergoing emergency UAE + CDB in the observation group, while there were no such cases in the control group (P < .05). An optimal cut-off value of 1.7cm for the length of placental edge crossed the cervical os in diagnosing prenatal hemorrhage demonstrated sensitivity and specificity of 75.0% and 86.7%, respectively (area under the ROC curve, 0.858).Conclusion:The combined therapy of mifepristone and Misoprostol/Ethacridine Lactate was useful for termination of mid-trimester pregnancy with placenta previa, and attention needs to be attached to prenatal hemorrhage during labor induction. Emergency UAE + CDB is a good combination method to treat prenatal hemorrhage and promote cervical ripening during the induction.

Acute Uterine Inversion Complicating Mid-Trimester Unsafe Abortion in a Teenage Nigerian Girl

Uterine inversion is a rare but life-threatening obstetric emergency, complicating 1 in 2,000 to 1 in 50,000 deliveries. Very rarely, this condition also complicates unsafe abortion. A case of acute complete (fourth-degree) uterine inversion, with gangrene of the uterus in an 18-year-old nulliparous girl who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, in hypovolemic shock from massive haemorrhage following unsafe mid-trimester termination of unwanted pregnancy is reported. She was adequately resuscitated, and a vaginal hysterectomy was performed. The patient was discharged following an uneventful postoperative period. This case highlights the consequences of the high unmet need for family planning and the restrictive abortion laws in Nigeria, limiting access to effective contraception and safe abortion services, thereby increasing the risk of maternal mortality and morbidity from complications of unsafe abortion

Lower uterine segment scar assessment at 11-14 weeks' gestation to screen for placenta accreta spectrum in women with prior Cesarean delivery.

To validate prospectively transvaginal ultrasound assessment of the lower uterine segment (LUS) scar at the time of first-trimester screening in women with previous Cesarean section (CS) and to determine its feasibility and accuracy in stratifying women according to the risk for placenta accreta spectrum (PAS) disorder. Women with a history of CS were recruited between 11 + 0 and 13 + 6 weeks' gestation and underwent LUS scar assessment using transvaginal ultrasound. A standardized midsagittal plane, which included the cervicoisthmic canal (CIC), the uterine scar and the placental site, was obtained. The scar was described in terms of its size (narrow or dehiscent) and its location in relation to the CIC (within or above), with each LUS scar classified into one of four groups based on these features. Placental location was assessed and classified as high- or low-lying. Women were stratified according to the risk of PAS, based on the relationship between the scar location and placental site. Women were considered high risk when the scar was above the CIC and the placenta was low-lying (i.e. when the placenta was overlying an exposed scar) and low risk when the scar was within the CIC and/or the placenta was high. High-risk patients were followed up at 20 weeks and 28-30 weeks for the development of PAS. Maternal demographics, detailed obstetric history and obstetric outcome were collected. First-trimester transvaginal ultrasound was offered to 535 women with prior CS during the study period. A LUS scar was visualized in 79.9% (401/502) of those who agreed to undergo the examination. At this scan, the LUS scar was above the CIC in 9.0% (36/401) of women, but only 5.7% (23/401)additionally had a low-lying placenta overlying the scar. Of these 23 high-risk women, two were found to have PAS on the mid-trimester screening scan and one was noted to have placental adherence during evacuation following mid-trimester termination of pregnancy. On the first-trimester scan, 94.3% (378/401) of women were at low risk of PAS. This screening protocol yielded a positive likelihood ratio of 21.33 (95% CI, 13.02-34.96), sensitivity of 100% (95% CI, 29.24-100%), specificity of 95.31% (95% CI, 92.39-97.35%), positive predictive value of 16.7% (95% CI, 5.8-39.2%) and negative predictive value of 100% (95% CI, 98.4-100%). On multivariable regression analysis performed to identify confounding variables associated with a LUS scar above the CIC, only maternal body mass index ≥ 30 kg/m2 was significant (odds ratio (OR), 2.42 (95% CI, 1.04-5.39); P = 0.03). Although there was a trend towards an increased risk of a LUS scar above the CIC in women with prior elective prelabor CS (OR, 1.72 (95% CI, 0.80-3.68)), this association did not reach statistical significance. Routine transvaginal ultrasound assessment of the location of the LUS scar and placenta at the time of first-trimester screening between 11 + 0 and 13 + 6 weeks' gestation in women with prior CS is a feasible and effective tool to identify those at risk of subsequent development of PAS disorder. A finding of placental implantation over an exposed LUS scar seems to be cardinal in predicting the risk of PAS disorder in women with prior CS, with an excellent negative predictive value. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Innovative mid-trimester termination of pregnancy in a COVID-19 critically Ill patient

The current COVID-19 pandemic has introduced many challenges on the presentation of the disease, effects of the disease on co-morbidities of the patient and the management of these. This has necessitated innovative ways of managing these patients. This is particularly so in pregnant women with COVID-19. We present a case of a pregnant woman in her mid-trimester who presented with severe COVID-19 disease requiring ICU admission who required termination of pregnancy due to worsening condition while on ventilator. She presented with high fever, cough and difficulty in breathing. These rapidly deteriorated requiring ECMO. Her liver function, kidney function and inflammatory markers equally deteriorated very fast despite various treatments including using convalescence plasma. We decided to terminate the pregnancy to help in managing her condition. The baby died just when we were considering the termination of the pregnancy thus requiring Mid-trimester termination of the non-viable pregnancy. We initially tried to use vaginal misoprostol for the termination but failed thus we had to find a way of using mifepristone pre-treatment for the termination. An innovative used of mifepristone through the nasogastric tube was devised and we successfully terminated the pregnancy with mifepristone pre-treatment followed by a single dose of misoprostol with minimal blood loss. The patient’s condition improved rapidly after the termination of pregnancy and she recovered fully. We feel her pregnant status might have contributed to her severe symptoms and the disease may have contributed to the demised of the baby. We recommend the use of mifepristone through the nasogastric tube in the process of termination of pregnancy in a sick ventilated patient.

Hysteroscopy and Retained Products of Conception: An Update.

Retained products of conception (RPOC) can occur after early or mid-trimester pregnancy termination and also following vaginal or cesarean delivery. It is frequently associated with continuous vaginal bleeding, pelvic pain, and infection. Late complications include intrauterine adhesions formation and infertility. Conventionally, the management of RPOC has been with blind dilation and suction curettage (D and C); however, hysteroscopic resection of RPOC is a safe and efficient alternative. In this review, we analyze the current available evidence regarding the use of hysteroscopic surgery for the treatment of RPOC comparing outcomes and complications of both traditional curettage and hysteroscopic technique. Data search has been conducted using the following databases MEDLINE, EMBASE, Web of Sciences, Scopus, Clinical Trial. Gov., OVID, and Cochrane Library interrogate all articles related to hysteroscopy and the preserved product of conception, updated through September 2020.

Misoprostol only or in combination with intra cervical Foley’s catheter for termination of the second trimester demise pregnancy in patient with previous caesarean sections

Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value&gt;0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.

Randomized controlled trial between vaginal misoprostol alone versus weighted intrauterine Foley’s catheter and vaginal misoprostol in termination of mid-trimester abortion

the uterus instead of spontaneous onset of the process irrespective of duration of pregnancy.Aim: This work aimed to investigate whether the insertion of a weighted fluid filled trans-cervical Foley’s catheter in women undergoing midtrimester termination of pregnancy for various reasons; may further improve the effectiveness of vaginal misoprostol in terminating their pregnancies.Materials and Methods: A prospective, interventional, randomized controlled trial was conducted on a total number of 50 patients divided into two groups; the first group (I) included 25 patients who received vaginal misoprostol, two tablets each contains 200 microgram misoprostol (Segma pharmaceuticals, Egypt) in the posterior vaginal fornix every four hours. The mean induction delivery interval was 23.17 ± 6.19 in group I, 18.47 ± 7.34 in group II (25% reduction).Results: The use of a weighted trans-cervical Foley’s catheter filled with 30 ml saline improve the effectiveness of 400 μg vaginal misoprostol in terminating mid trimester pregnancies as reflected by a shorter induction to delivery interval with no significant increase in the incidence of side effects.Conclusion: The use of a weighted trans-cervical Foley’s catheter filled with 30 ml saline improve the effectiveness of 400 μg vaginal misoprostol in terminating mid trimester pregnancies as reflected by a shorter induction to delivery interval with no significant increase in the incidence of side effects.

Subacute uterine inversion following an induced abortion in a teenage girl: a case report

BackgroundSubacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs.Case presentationWe present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene.ConclusionOur case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

Medical Induction for Mid trimester Abortion: A Hospital-based Descriptive Cross-sectional Study.

Second trimester abortion is known as termination of pregnancy from 13- 28 weeks of gestation which can be further divided into early second trimester as 13-22 weeks and late as 23-28 weeks. In our study we have limited up to early second trimester. We intend to see the success rate of combination of mifepristone and misoprostol for medical induction, median time required for expulsion, complication and need of dilation and evacuation in some cases. This study also aims to give a review of current literature in mid trimester abortion with respect to efficacy, complication and also to provide evidencebase recommendation for safe regimens for mid trimester pregnancy termination. This was hospital-based descriptive cross-sectional study conducted among 40 pregnant women at second trimester admitted for termination of pregnancy in Kathmandu medical collage teaching hospital for the period of six month. Ethical approval was taken from the Institutional Review Committee of Kathmandu Medical College (Ref: 2207202002). Convenient sampling was done. All the pregnant women who need to terminate their pregnancy at second trimester (13-22 weeks) were admitted at Kathmandu Medical College Teaching hospital for termination of pregnancy were included in the study. Among the 40 women, who had termination of pregnancy at second trimester 37 (92.5%) had successful medical termination whereas 3 (7.5%) needed dilatation and evacuation. The combination of Mifepristone and Misoprostol have excellent result for termination of pregnancy if appropriately used after evaluating the patient with minimal complications.

Mid Trimester Termination of Pregnancy : Role of Combined Mifepristone and Misoprostol

Background: Mid trimester abortions constitute 10%-15% of all induced abortionsworld wide. Over the last decade this increase is due to better prenatal screening. Itcan be done by surgical and medical methods. Medical methods such as Misoprostolis widely used for mid trimester abortion. Mifepristone has antiprogesteroneproperty,so addition of Mifepristone with Misoprostol can increase its effectiveness.To assess the safety, effectiveness and acceptibility of combined Mifepristone andMisoprostol for mid trimester medical termination of pregnancy (Between 13-24weeks of gestation).&#x0D; Materials and methods: This experimental study was conducted among 40 healthywomen who presented for mid trimester termination of pregnancy between 13-24weeks with missed abortion, gross congenital anomalies with or without previoushistory of one caesarian section. The study was conducted from March October2018 at Chattogram Maa-O-Shishu Hospital Medical College, Chattogram,Bangladesh. Each woman received a single dose of tablet Mifepristone 200mg. After24 hours, 200 mcg vaginal Misoprostol was administered which was repeated at 6hourly interval for maximum of 5 doses (1000 mcg) in 24 hours. Success was takenas complete expulsion of fetus and placenta within 24 hours of first dose ofMisoprostol. Primary and secondary outcomes were measured. Statistical analysiswas done using SPSS version 23.&#x0D; Results: Success rate of complete abortion was 97.5%. Mean Induction AbortionInterval was11.59 hours (SD± 3.34). Mean dose of Misoprostol was 1.85 (SD± 0.77)or 370 mcg. Over all safety of the study was satisfactory with only 1 patientexperienced fever and 1 had nausea .There was no major complication.&#x0D; Conclusion: The Mifepristone/Misoprostol regimen is a highly effective as well assafe option for mid trimester medical termination of pregnancy with a shortinduction abortion interval and it can also be used in scarred uterus with closesupervision.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 63-67

Study of Mifepristone and Misoprostol Vs Misoprostol alone in mid trimester termination of pregnancy in tertiary care hospital

Study of Mifepristone and Misoprostol Vs Misoprostol alone in mid trimester termination of pregnancy in tertiary care hospital

456 Sexual and reproductive health in women undergoing mid-trimester pregnancy termination (MTPT) below 24 weeks of gestational age (GA) in a single obstetric unit in Singapore

456 Sexual and reproductive health in women undergoing mid-trimester pregnancy termination (MTPT) below 24 weeks of gestational age (GA) in a single obstetric unit in Singapore

The Effect of Vaginal pH on the Efficacy of Vaginal Misoprostol for the Induction of Midtrimester Pregnancy Termination

The Effect of Vaginal pH on the Efficacy of Vaginal Misoprostol for the Induction of Midtrimester Pregnancy Termination