COMPARISON OF USE OF LOW DOSE VAGINAL MISOPROSTOL FOR SECOND AND EARLY THIRD TRIMESTER PREGNANCY TERMINATION IN WOMEN WITH PRIOR CAESAREAN AND UNSCARRED UTERI

Öz

Objective: The study was aimed to determine the safety and efficacy of the vaginal administration of low dose misoprostol for late pregnancy termination in women with prior caesarean and unscarred uteri.

Study design: A retrospective study was carried out from January 2008 to June 2012 on 209 pregnant women who underwent termination of pregnancy in the second and early third trimester. Among the women, 173 did not have a uterine scar (Group 1) while 36 had a history of prior caesarean (Group 2). The induction-to-abortion interval, the rate of complications and failureand the need for a different method during the process were assessed.

Results: In group 1, 145 of patients (83.8%) delivered vaginally in 48 hours, the mean duration of the induction-to-abortion interval was 21±10.3 hours. In this group, 11 patients (6.3%) needed one or more different methods and one case of uterine rupture (0.57%) was observed. In group 2, 26 of patients (72.2%) delivered vaginally in 48 hours (p=0.11), the mean induction-abortion interval was 22.7±10.8 hours (p=0.45). Six patients (16.7%) needed a different method (p=0.05) and there was also one case (2.7%) of ruptured uterus (p=0.28).

Conclusion: Administration of low-dose vaginal misoprostol appears to be effective without excessive side effects or complications for late pregnancy termination.

Key words: Misoprostol, pregnancy termination, uterine rupture,

Anahtar Kelimeler

• Misoprostol,pregnancy termination,uterine rupture

GEÇİRİLMİŞ SEZARYEN ÖYKÜSÜ OLAN VE UTERİN SKARI OLMAYAN GEBELERDE İKİNCİ VE ERKEN ÜÇÜNCÜ TRİMESTER TERMİNASYONLARINDA DÜŞÜK DOZ VAGİNAL MİZOPROSTOL KULLANIMININ KARŞILAŞTIRILMASI

Öz

Amaç: Geçirilmiş sezaryen veya uterin cerrahi öyküsü olan ve olmayan hastalarda geç gebelik terminasyonlarında düşük doz vaginal mizoprostol uygulamasının güvenilirliği ve etkinliğinin belirlenmesi amaçlandı. Yöntem ve Gereç: Ocak 2008 ile Haziran 2012 tarihleri arasında ikinci veya erken üçüncü trimesterde gebelik terminasyonu yapılan 209 gebe retrospektif olarak değerlendirildi. Gebelerden 173’ünde uterin skar bulunmazken (Grup 1), 36’sında daha önce sezaryen hikayesi mevcuttu (Grup 2). İndüksiyon ile abortus arasında geçen süre, komplikasyon oranı, başarısızlık oranı ve bu süreçteki ek girişim gereksinimi değerlendirildi. Bulgular: Grup 1’deki hastaların145’inde (%83,8), ilk 48 saatte vaginal doğum olurken, indüksiyonla abortus arasındaki ortalama süre 21±10,3 saat idi. Bu gruptaki hastaların 11’inde (%6,3) bir veya daha fazla ek girişim gerekirken, bir olguda (%0,57) uterin rüptür gözlendi. Grup 2’de ise hastaların 26’sında (%72,2) ilk 48 saatte vaginal doğum olurken (p=0.11) indüksiyonla abortus arasındaki ortalama süre 22,7±10,8 saat idi (p=0.45). Altı hastada (%16,7) ek girişim gerekirken (p=0.05), bir olguda (%2,7) uterin rüptür görüldü (p=0.28). Sonuç: Geç gebelik terminasyonlarında düşük doz vaginal mizoprostol, belirgin yan etki veya komplikasyona sebep olmaksızın uygulanabilir görünmektedir

Anahtar Kelimeler

• Mizoprostol, gebelik terminasyonu, uterin rüptür

Kaynakça

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