Termination Of Second Trimester Pregnancy Research Articles

Could vaginal misoprostol be effective in second-trimester pregnancy termination in women with a previous uterine scar

Could vaginal misoprostol be effective in second-trimester pregnancy termination in women with a previous uterine scar

İkinci Trimester Gebelik Sonlandırmalarında Misoprostolün Etkinliğinin, Güvenilirliğinin ve Maliyetinin Değerlendirilmesi

Objective: The aim of the study was to evaluate the efficacy, safety, cost analysis and complications of the misoprostol protocol of our clinic (using intravaginal misoprostol after using oral misoprostol) in the second trimester termination of pregnancy. Methods: The study was designed in Gynecology & Obstetrics Clinic of Suleymaniye Maternity Training and Research Hospital, Istanbul between January 2010 and July 2011. Eighty patients, of whose pregnancies were terminated at 14-28 weeks of gestation, were retrospectively analyzed. The patients were separated into two groups as with and without a history of previous cesarean section. 200 mcg misoprostol was applied vaginally to the group without a history of previous cesarean section, and then 4 doses of 400 mcg misoprostol was applied orally every 4 hours. Patients with a prior cesarean delivery were administered 200 mcg misoprostol vaginally, and 200 mcg misoprostol was applied every 4 hours orally. Findings of the cases at 24th and 48th hours were recorded. The method was considered to fail in cases that birth does not happen after 48 hours. Results: Delivery/abortion was carried out in 85%of patients (68 cases) during the first 48 hours. The number of patients, who gave birth in the first 24 hours, was 43. The success rate in the first 24 hours was 53.75%. Ten out of 13 patients with a history of previous cesarean section had abortion in the first 48 hours. The success rate in the first 48 hours was 76.9%. Only 3 cases (3.75%) had fever and one case (1.25%) had cervical laceration. Conclusion: Our study shows that our misoprostol protocol which we used in the second trimester termination of pregnancy is safe, effective and acceptable in terms of cost. However, there is no consensus yet about the dose and the most effective application method of misoprostol.

Termination-of-Pregnancy Rights and Foetal Interests in Continued Existence in South Africa: The Choice on Termination of Pregnancy Act 92 of 1996

The aim of this article is to demonstrate that, although South Africa has permissive termination-of-pregnancy legislation, to the extent that women can terminate firstand second-trimester pregnancies on demand and for socio-economic reasons, foetal interests are in fact taken into account. The system of female reproductive rights progressively shelters foetal interests, albeit to a limited extent. South Africa is in the process of successfully balancing the conflicting notions of female reproductive rights and foetal interests. The article discusses the "right to terminate a pregnancy" with reference to the Constitution, the Choice on Termination ofPregnancy Act 92 of 1996 and relevant case law. On the topic of foetal interests, the article looks at the Choice on Termination of Pregnancy Act as legislative recognition of foetal interests since a woman's right to terminate her pregnancy is progressively limited as the pregnancy advances beyond the second trimester. The value of dignity justifies the recognition of foetal interests. Further, accepting that the Choice on Termination of Pregnancy Act limitedly protects foetal interests based on the value of dignity, the article questions why South Africa permits elective second trimester termination of pregnancies? Research indicates a need for second trimester terminations and the article discusses the position of a number of women seeking second trimester terminations. The article draws to an end by looking at the case of S v Mshumpa as an example ofthe balancing process that is needed when dealing with female reproductive rights and foetal interests. This article demonstrates the constitutional setting of women's termination-of-pregnancy rights on the one hand, and foetal interests on the other. Further, it illustrates that these conflicting positions, rather than being deepened, are in fact balanced by legislation and relevant case law.KEYWORDS: Choice on Termination of Pregnancy Act; female autonomy; foetal interests; value of dignity; second-trimester termination of pregnancy

Can isosorbide mononitrate be useful in second trimester termination of pregnancies?

BackgroundIsosorbide mononitrate (IMN) administration is thought to enhance in the cervical ripening process. We sought to identify the clinical usefulness and safety of IMN administration for shortening the time to termination of the second trimester pregnancy procedures when used in addition to misoprostol. Study DesignWomen were randomly selected to receive either the standard misoprostol treatment (control group) or, additionally, receive vaginally IMN as well as the misoprostol treatment. ResultsThe mean induction to complete abortion interval was 20.4 h [95% confidence interval (CI)=16.63–24.17] in the misoprostol group compared with 12.4 h (95% CI=10.33–14.47) in the misoprostol plus IMN group. This difference was statistically significant (p<.05). In the subgroups of nulliparas and multiparas, the shortening effect of the IMN was also statistically significant. ConclusionsA net benefit after the combined use of IMN and misoprostol was noted. Therefore, we believe that IMN has a clinical role in the ripening process.

Misoprostol-induced termination of secondtrimester pregnancy in women with a history of cesarean section: A retrospective analysis of 56 cases

To assess the effectivity and safety of misoprostol induced termination of pregnancy in the second trimester in women with a history of previous caesarean section. Retrospective analysis of case records from the obstetrics and gynecology department of a tertiary care center between January 2009 and February 2012 was performed. Data derived from 219 women, who underwent a second trimester termination of pregnancy, was analyzed in terms of demographics, clinical findings, laboratory and procedural data. The study group consisted of 56 women with a previous caesarean section and the control group was composed of 163 women without such a history. Termination of pregnancies was conducted by administration of misoprostol at doses of 50-600 mcg intravaginally or by surgical evacuation in cases of failure of medical measures. There was no statistically significant difference between two groups in terms of demographics such as age, menarche, number of pregnancies or live births, smoking habit and co-morbidities. Necessity for blood transfusion (p = 0.05) and additional procedure for abortion (p = 0.056) were found to be similar in both groups. However laparotomy (p = 0.004), uterine rupture (p = 0.016), hysterotomy (p < 0.001) were performed more frequently in the study group; while abortion was more likely to occur within 24 hours in the control group (p = 0.031). Medical abortion must be carefully used for the termination of second trimester pregnancies in women with a history of CS. Increased possibility of uterine rupture and requirement of interventions such as laparotomy or hysterotomy is more likely in these patients.

Combined oral and vaginal misoprostol use in therapeutic terminations at 14 to 28 weeks of gestation

This study involved an investigation of the effectiveness and complications of oral and vaginal misoprostol use on the termination of second trimester pregnancies. A total of 103 cases were recruited from the medical records of the Gynecology and Obstetrics Clinic of Taksim Research and Training Hospital and AžA±rnak A°dil State Hospital. Women underwent therapeutic termination of pregnancy between the 14 to 28th week of gestation using the defined combined misoprostol regimen. After the women were admitted, 200 μg vaginal (100 μg intracervical, 100 μg into the posterior fornix), 200 μg oral doses and 200 μg of sequential doses were administered in the 2nd and 4th hour. Subjects were excluded from the study if they were out of the defined gestational weeks using additional drugs with misoprostol; their data has not been recorded in detail. Of the 103 cases, 86 had an abortion within 24 h and the mean expulsion time was calculated as 15.42 ± 7.14 h (min 6.39 to max 20.03) in this group. The success rate for the 24 h was found to be 83.4%. Six more cases had an abortion when the second dose was given. The mean expulsion time was found to be 9.31 ± 3.26 h (min 6.45 to max 13.21) for the second 24 h. The success rate over 48 h rose to 89.3%. The total expulsion time was 18.30 ± 8.74 h. There was a history of previous caesarean sections in 2 out of 11 cases that did not have an abortion and one of these cases underwent a hysterotomy. The pregnancy was terminated by evacuation and curettage, as abortion did not occur despite 3 different high dose misoprostol regimens as in the other cases. Pregnancies of the remaining 9 cases were terminated with different misoprostol doses, oxytocin infusion and the evacuation and curettage method. When complication rates were evaluated, analgesic requiring pain (18.4%) was the leading complication, followed by nausea (11.6%), fever (7.7%), headaches and dizziness (5.8%), transfusion-requiring haemorrhage (3.8%) and diarrhea (1.9%). Uterine rupture or death did not occur. A combined misoprostol regimen is relatively safe with acceptable side effects when used carefully for the termination of second trimester pregnancies. Keyword: Misoprostol, Pregnancy Trimester. Second, Termination of Pregnancy, Mean Expulsion Time, Medical Termination, Vacuum Curettage, Side Effects

Agreement Between Prenatal Ultrasonography and Fetal Autopsy Findings: A Retrospective Study of Second Trimester Terminations of Pregnancy

To estimate the agreement between prenatal ultrasonography observations at 16 - 21 gestational weeks and fetal autopsy findings in pregnancies terminated because of fetal anomalies. This 4½ year retrospective study includes consecutive fetuses that were terminated because of fetal malformation and/or chromosomal anomaly diagnosed in the second trimester. Only fetuses that had undergone fetal anatomy scanning by an obstetrician trained in fetal ultrasound before the termination and with available fetal autopsy reports were included. The cases were identified through the malformation registry database of our ultrasound unit. The sensitivity and specificity of ultrasound were calculated per organ system. When estimating the agreement between ultrasound results and autopsy findings, the cases were allocated to one of four categories according to the degree of concordance between ultrasound and autopsy findings: full agreement, near match, partial agreement and unconfirmed ultrasound findings. 71 of 95 pregnancy terminations due to fetal malformations met the inclusion criteria and constitute our study population. The sensitivity of ultrasonography with regard to malformations in the brain and spine was 100 % (27/27) and with regard to malformations in the internal organ system (including malformations in the urogenital and gastrointestinal systems and in the abdominal wall and diaphragm) was 91 % (30/33). The corresponding figures for malformations in the cardiovascular and skeletal organ systems were 63 % (17/27) and 71 % (25/35), respectively. The specificity was lowest for malformations in the central nervous system and internal organ system (33/38, 87 % and 39/44, 89 %, respectively). There was full agreement between the ultrasound and autopsy findings in 44 % (31/71) of all cases and a near match in 46 % (33/71) of cases. In almost 10 % (7/71) of the pregnancies, the ultrasound findings were only partially confirmed or not confirmed by autopsy. In one case the discrepancy between the ultrasound and autopsy findings suggests that the pregnant woman might have decided to terminate the pregnancy on the basis of incorrect interpretation of ultrasound findings. Even though the agreement between ultrasound and autopsy findings was acceptable from a clinical point of view, agreement with regard to the detailed description of malformations was far from perfect. The detection rates were suboptimal for the cardiovascular and skeletal organ systems.

Sublingual versus vaginal misoprostol for second trimester termination: a randomized clinical trial

To evaluate the efficacy of two routes of administration of misoprostol (sublingual and vaginal) for medical termination of second trimester pregnancies. One hundred and thirty-four women referred for second trimester termination were enrolled in this randomized clinical trial. They were divided to receive 400 μg every 6 h misoprostol either sublingually or vaginally. They were followed for 48 h, at which point they underwent D&C if the termination was not complete. Efficacy was defined as successful termination without the need for interventions. There were no differences between the vaginal and sublingual groups in terms of tablets mean dose of misoprostol applied (1360 ± 2.4 vs. 1320 ± 2.3) or endometrial thickness after termination of pregnancy (13.02 ± 5.2 vs. 13.3 ± 6.6 mm). The success rate was 61.2 % (n = 41) in the vaginal group versus 70.1 % (n = 47) in the sublingual group (p = 0.3). Twenty-six patients (38.8 %) in the vaginal group underwent D&C due to retained tissue, compared with 20 patients (29.8 %) in the sublingual group. In primigravids, the success rate was significantly higher in the sublingual group than vaginal group. There was no significant difference with regards to complications between the two groups. The sublingual route of misoprostol administration has the same efficacy as the vaginal route and can be applied for second trimester pregnancy termination in primigravid women in outpatient settings due to its simple administrations.

Complications of surgical termination of second-trimester pregnancy in obese versus nonobese women

BackgroundObesity is becoming increasingly common in obstetric and gynecologic populations, which may affect the safety of surgical termination of pregnancy. Study DesignWe performed a retrospective review of all patients undergoing second-trimester surgical termination of pregnancy by under ultrasound guidance termination between 13 0/7 and 24 0/7 weeks of gestational age (GA) to compare perioperative risks in obese and nonobese women. Complication rates, operative times and anesthesia times were compared between obese [body mass index (BMI) ≥30 kg/m2] and nonobese women (BMI <30). ResultsOf 1044 women, 29.0% were obese. The mean complication rate was 6.1% and similar between groups (5.5% nonobese, 7.6% obese, p=.20). Operative times were 4.4 min longer and mean anesthesia times were 5 min longer in obese patients (p<.001 for each). There was a nonsignificant trend toward more complications with gestational ages above 18 weeks (5.5% vs. 7.7%, p=.20). A history of one or more cesarean sections had an independent association with major complications after adjustment for confounders (adjusted odds ratio 4.2, p=.001). ConclusionsBoth anesthesia and operative times were modestly increased in obese women versus nonobese women undergoing second-trimester surgical termination, without significant differences in complication rates. For patients at advanced GA with prior cesarean delivery, clinicians should be aware of the potential increase in complications as well as increased operative time in obese women, and counsel appropriately.

Multiple-dose vaginal misoprostol and single-dose misoprostol plus oxytocin for termination of second-trimester pregnancy

ObjectiveTo compare 2 different methods—multiple doses of misoprostol and a combination of misoprostol and oxytocin—for termination of pregnancy in the second trimester. MethodsBetween 2006 and 2008, 120 women undergoing termination of second-trimester pregnancy in 2 hospitals in Kermanshah, Iran, were enrolled in a randomized trial comparing 2 treatments. In each treatment group, an initial vaginal dose of 600μg of misoprostol was placed in the posterior fornix. After 6hours, an intravenous infusion of concentrated oxytocin was given to women in group A, and 400μg of vaginal misoprostol was given every 6hours to women group B, up to a maximum of 4 doses. The outcomes were compared via χ2 and independent t tests. ResultsWithin 30hours, 96.7% of women in group A and 96.7% of women in group B delivered successfully. The average duration between induction and delivery time was 12.3±6.0hours in group A and 12.1±6.0hours in group B (P>0.05). ConclusionThe use of misoprostol with oxytocin, and multiple doses of misoprostol gave similar results for termination of pregnancy in the second trimester.

Risk factors of surgical evacuation following second-trimester medical termination of pregnancy

BackgroundSecond-trimester medical termination of pregnancy (TOP) is associated with a higher risk of surgical evacuation than earlier medical TOP. Little is known about risk factors of surgical evacuation. Therefore, we assessed these risk factors among women undergoing second-trimester medical TOP. Study DesignData on 227 women were derived from a prospective randomized trial comparing 1- and 2-day mifepristone–misoprostol intervals in second-trimester medical TOP between 2008 and 2010. ResultsThe rate of surgical evacuation was 30.8%. The risk of surgical evacuation was increased by a history of curettage [odds ratio (OR) 4.4; 95% confidence interval (CI) 1.7–11.7], fetal indications for TOP (OR 6.1; 95% CI 1.1–34.4), age above 24 years (OR 2.4; 95% CI 1.1–5.3) and a 2-day interval (OR 2.2; 95% CI 1.1–4.1). ConclusionsHistory of curettage, fetal indication, increasing age and 2-day interval between mifepristone and misoprostol increase the risk of surgical evacuation in cases of second-trimester medical TOP. These findings are important when optimizing clinical service in second-trimester TOP.

Efficacy and safety of vaginal misoprostol in second trimester medical termination of pregnancy

Search for safe and effective method for second trimester termination of pregnancy continue from the time, when pregnancy termination was legalized through MTP act in India. With the knowledge about the potent uterotonic potential of misoprostol ,a synthetic prostaglandin analog , it is being (off label) used for second trimester termination of pregnancy with satisfactory results .Various dosage schedules and routes have been tried for this purpose .Present study was carried out to know the efficacy and safety of vaginal administration of misoprostol for second trimester of pregnancy .One hundred forty eight women seeking termination of pregnancy in second trimester, for various indications as per MTP act, over three years period at government approved MTP center, attached to Medical college hospital, were included in the study .Initial dose of 400 microgram of misoprostol by per vaginal route ,followed by 200 microgram was used for induction of abortion. Overall success rate was 92 percent and average induction abortion interval was 14 hours .There were no serious side effects or complications related to misoprostol .Average dose required for complete abortion was 1200 micrograms .Misoprostol was found to be safe and effective for second trimester medical termination of pregnancy.

First Trimester Abortion: A Rare Cause of Intrauterine Bony Spicules

Bony fragments in the uterus occur after second trimester termination of pregnancy following retained fetal bones. Very rarely, they can form following first trimester loss. Clinical symptoms range from pain, menstrual symptoms, and infertility. Ultrasound shows a hyperechoic shadow, and treatment is by curettage or hysteroscopic removal.

SECOND TRIMESTER PREGNANCY

Objective: To compare clinical efficacy and side effects of oral misoprotol with vaginal misoprostol for termination of second trimester pregnancy. Design: Interventional Quasi experimental. Setting: Gynae Unit III, Liaquat University Hospital, Hyderabad. Period: 1st March 2006 to 31st August 2006. Methodology: Sixty patients were selected with thirty in each group i.e thirty for oral route (group A) and thirty for vaginal route(group B). The patients included in this study were those having singleton pregnancy with gestational age between 12 to 26 weeks requiring termination of pregnancy. A dose of 100ug to 200ug was used with maximum of 1200ug in each group of patients. Results: The subjects of either group were similar with respect to mean age, height, weight, parity, gestational age and pre induction Bishop Score. The success rate in group A was 94.4% as compared to group B was 86.8%. intra uterine death was the commonest indication in both groups found in 46.7% women of vaginal misoprostol group and 50% women of oral misoprostol group. Surgical evacuation was needed in 36.7% women of oral misoprostol group and 16.7% women of vaginal misoprostol group. Conclusions: The present study shows misoprostol to be effective for mid trimester abortions, both orally and vaginally, the later route is preferable because it requires lesser doses and produces a shorter induction – abortion interval. However safety data are needed to guide the route choice and well designed studies are necessary.

Profiles of women presenting for abortions in Singapore: focus on teenage abortions and late abortions

Teenage abortions predispose women to adverse pregnancy outcomes in subsequent pregnancies such as anemia, stillbirths, preterm deliveries and low birth weight babies. We aim to profile the women presenting for abortions in our institution and determine risk factors for late presentation for abortions. In this retrospective cohort study, all women who underwent an abortion at the National University Hospital, Singapore, from 2005 to 2009 were recruited. Data was obtained from a prepared questionnaire during the mandatory pre-abortion counseling sessions. Profiles of women aged <20 years were compared with those ≥ 20 years old using Chi-square test if the assumptions for Chi-square test were met; otherwise, Fisher's exact test was carried out. Logistic regression was used to investigate the risk factors for second trimester termination of pregnancy. 2109 women presented for induced abortions, of which 1998 had single abortion throughout the course of the study. The mean age of women with single abortion was 29.1 years (sd 7). In the group of women with single abortion, 182 (9.1%) were teenage abortions. In contrast to women ≥ 20 years of age, pregnant teenagers were more likely not to have used any contraception (51.1% vs. 25.2%) and more likely to present late for abortions (39.6% vs. 15.9%). Other risk factors for late presentation for abortions include Malay ethnicity, singlehood, nulliparity and lack of prior usage of contraception. Teenagers are more likely to have no prior contraceptive usage and to present late for abortions. Lack of proper sexual education and awareness of contraceptive measures may have a major contributory factor to such a trend in teenage abortions. Recommendations have been made in order to curb this societal problem.

One- and two-day dosing intervals between mifepristone and misoprostol in second trimester medical termination of pregnancy--a randomized trial

The recommended time interval between mifepristone and misoprostol in medical second trimester termination of pregnancy (TOP) has been 36-48 h. However, a more flexible interval would be of value. The aim of this investigation was to compare one- and two-day intervals in second trimester medical TOP. The main outcome measures were induction-to-abortion time and the rate of surgical evacuation. This open randomized trial included 227 women undergoing TOP between gestational weeks 13-24. Mifepristone (200 mg) was followed by misoprostol (400 mcg) after one (17-28 h) or two (41- 45 h) days. In intention-to-treat analysis, the median induction-to-abortion interval was 1h longer in the one-day group (8.5 versus 7.2 h, P = 0.038), but in per-protocol analysis, the rate of surgical evacuation was higher in the 2-day group [30/115 (25%) versus 40/112 (37%); 95% confidence interval 0.3-24.1, P = 0.044]. A subgroup analysis showed that the median induction-to-abortion interval was 3h longer in the one-day group, amongst women without previous vaginal deliveries (10.1 versus 7.6, P = 0.013) and when gestation exceeded 16 weeks (10.8 versus 7.2, P = 0.024). Both one- and two-day dosing intervals seem to be suitable for second trimester medical TOP, but women with no previous deliveries and those whose gestation exceeds 16 weeks may benefit from the longer interval. However, evaluated on the basis of surgical evacuation, the one-day interval could be supported as an option for second trimester medical TOP. Effective use of both one- and two-day dosing intervals is important when optimizing clinical service. ISRCTN09944151.

Mifepristone may shorten the induction-to-abortion time for termination of second-trimester pregnancies by ethacridine lactate

BackgroundWe reviewed our experience with adding mifepristone to the protocol for the termination of pregnancy up to 24 weeks of gestation by intra-amniotic ethacridine lactate. Study DesignThe study consisted of women who presented for the termination of a second-trimester pregnancy between August 2000 and July 2008. ResultsOf 1245 women who requested a termination of a second-trimester pregnancy, 744 women underwent the induction of abortion by intra-amniotic ethacridine lactate with mifepristone (mifepristone group), and 501 received intra-amniotic ethacridine lactate alone (control group). The proportion of women who delivered within 24 h was 25.94% in the mifepristone group and 10.18% in the control group (p<.001); the failure rate of abortion was 5.38% in the mifepristone group and 4.99% in the control group (p<.001). There was no significant difference in the complication rate between the two groups. The rate of cervical laceration was 0.54% in the mifepristone group and 0.60% in the control group (p=.9315). The rate of retained placental tissue was 6.99% in the mifepristone group and 6.19% in the control group (p=.1112). Nausea was reported by 34.0% of women in the mifepristone group and none in the control group. ConclusionThe addition of mifepristone to ethacridine lactate may shorten the induction-to-abortion time compared with the use of ethacridine lactate alone without increasing the number of complications.

A randomized comparative study on vaginal administration of acetic acid-moistened versus dry misoprostol for mid-trimester pregnancy termination

Absorption and effectiveness of vaginally administered misoprostol tablets may vary according to the medium in which it is placed. This study was directed to compare the outcomes of vaginal administrations of acetic acid-moistened misoprostol tablets with those of dry tablets for induction of second-trimester abortion. A randomized comparative trial where 322 women at 13-20 weeks gestation, requiring medical abortion, were randomly assigned to vaginal administration of either acetic acid-moistened or dry misoprostol tablets with a dose schedule of 400 μg three-hourly, up to a maximum five doses over 24 h. The same doses were repeated for another 24 h in nonresponders. Primary outcome measure was complete abortion rate at 24 and 48 h, and the secondary outcome measures were induction-abortion interval, failure rate and side effects. A difference of 15% in success rates at 24 h was used to calculate the sample size required with a power of 0.8 at the 5% significance level. No statistically significant differences in the complete abortion rates were observed at 24 h (70.95 vs. 68.71%, P = 0.675) and at 48 h (86.49 vs. 84.35%, P = 0.604) when both groups were compared. The difference in mean induction-abortion interval was also statistically insignificant between the groups (12.5 ± 1.6 vs. 12.8 ± 1.5 h, P = 0.97). Other outcome measures were also comparable in both groups. Moistening misoprostol tablets with 5% acetic acid before vaginal application creates no difference in outcomes when compared with those after the vaginal application of dry tablets for the termination of second-trimester pregnancy.

Low-dose vaginal misoprostol in the management of intrauterine fetal death

Objectives. To assess the effectiveness and side effects of vaginal misoprostol (Vagiprost® tablet) termination of second and third trimester pregnancy complicated with intrauterine fetal death (IUFD).Design. A prospective observational cohort study.Setting. Tanta University Hospital.Patients. The study carried out on 324 women with fetal demise in the second and third trimesters, from January 2008 to December 2009.Intervention. All patients were subjected to history taking, physical examination, and the Bishop Scoring. Application of 25 μg misoprostol in the posterior fornix of the vagina, this was repeated every 4 h over 24 h. We assessed the adverse effects, progress, and outcomes.Results. The success rate was 90% and 45% in women in the third and second trimesters, respectively. The mean induction-termination interval was 8.95 ± 2.63 and 15.3 ± 5.37 h for women in the third and second trimesters, respectively. The induction termination interval correlated negatively with the duration of gestation. Approximately, 90% of second trimester and 55% of third trimester women required oxytocin augmentation. The mean value of total required dose of misoprostol was 166.3 ± 7.5 and 120 ± 28.79 μg for women in the second and third trimesters, respectively.Conclusion. Vagiprost appears to be a safe, effective, practical, and inexpensive method for termination of third trimester pregnancy complicated with of IUFD.

Comparison of Preliminary Clinical Efficacy for Two Cervical Preparations for Early Second-trimester Pregnancy Termination at 12-17 Weeks Gestation

Objective To compare clinical efficacy for two cervical preparations for early second-trimester pregnancy termination at 12-17 weeks gestation. Methods Seventy healthy women aged 18-41 years requesting legal termination of pregnancy at 12-17 weeks of gestation were equally randomized into two groups. Two cervical preparations, the Dilapan-S™ combined with mifepristone and misoprostol (DMM) method, and the mifepristone combined with misoprostol (MM) method, were used to end early second-trimester pregnancy for group DMM and group MM, respectively. Clinical outcomes and complications for these two methods were compared. Results No differences were found on rates of successful abortion within 48 h and blood loss after abortion at 2 h between the two groups (P>0.05). DMM group had significant shorter induction-to-abortion interval and hospital stay compared with group MM (P 0.05). Conclusion DMM method would have similar clinical efficacies with MM method for early second-trimester pregnancy termination. Besides, DMM method has shorter induction-to-abortion interval and hospital stay, which benefits its clinical application.