Balloon Cervical Catheter for Second-Trimester Pregnancy Termination: A Single-Center Retrospective Study

Yıl 2026, Cilt: 48 Sayı: 2, 298 - 303, 11.02.2026

Arzu Yorulmaz Melih Velipaşaoğlu

https://doi.org/10.20515/otd.1791896

https://izlik.org/JA97EY73CW

Öz

To compare the effectiveness and safety of vaginal misoprostol alone versus misoprostol combined with a double-balloon catheter (DBC) for pregnancy termination at 12–22 weeks. Methods: Retrospective review of cases with perinatology board approval between January–September 2019. Primary outcome was induction‑to‑abortion interval; secondary outcomes were completion within 24 hours, bleeding (1 pad=40 mL), and complications. Results: Of 75 cases, 25 were excluded; 50 were analyzed (25/25). Induction‑to‑abortion interval was shorter with misoprostol (14.5 h [IQR 8.8–17.8]) than with misoprostol+DBC (24.3 h [17.2–45.5]) (p=0.0015). Completion ≤24 h: 92.0% vs 48.0% (p=0.0015; OR=0.08; 95% CI 0.02–0.42). Median bleeding was similar (20 mL vs 20 mL; p=0.944). Complications were rare and comparable in both groups (uterine rupture, post‑procedure curettage, transfusion: n=1 each per group). Conclusion: Misoprostol alone was associated with shorter time‑to‑abortion and higher 24‑hour completion without increased bleeding; adding a DBC did not provide a time advantage.

Anahtar Kelimeler

misoprostol , double balloon catheter , second trimester , pregnancy termination , induction

Proje Numarası

201911A214

İkinci Trimester Gebelik Terminasyonunda Vajinal Misoprostol ile Misoprostol+Çift Balon Servikal Kateter Kombinasyonunun Karşılaştırılması: Tek Merkezli Retrospektif Çalışma

https://izlik.org/JA97EY73CW

Öz

12–22. gebelik haftalarında terminasyon uygulanan olgularda, yalnız misoprostol ile misoprostol+çift balon kateter (ÇBK) protokollerinin etkinlik ve güvenliğini karşılaştırmak. Gereç ve Yöntem: Ocak–Eylül 2019 arasında tek merkezde yürütülen retrospektif kohortta olgular iki kola ayrıldı: yalnız misoprostol ve misoprostol+ÇBK. Birincil sonlanım indüksiyon‑abortus süresi (saat), ikincil sonlanımlar ilk 24 saatte terminasyon, kanama (40 mL/ped) ve komplikasyonlardı. Bulgular: Toplam 75 olgunun 25’i dışlama ölçütleri nedeniyle çıkarıldı; 50 olgu analize dâhil edildi (misoprostol n=25; misoprostol+ÇBK n=25). İndüksiyon‑abortus süresi medyanı misoprostolde 14,5 saat [ÇAA 8,8–17,8], misoprostol+ÇBK’de 24,3 saat [17,2–45,5] idi (p=0,0015). İlk 24 saatte terminasyon, misoprostolde %92,0 (23/25), misoprostol+ÇBK’de %48,0 (12/25) bulundu (p=0,0015; OR=0,08; %95 GA 0,02–0,42). Kanama medyanı her iki kolda 20 mL idi (p=0,944). Komplikasyonlar her iki kolda nadirdi (uterin rüptür, küretaj, transfüzyon: her kolda n=1). Sonuç: Yalnız misoprostol, ÇBK eklenmesine göre daha kısa süre ve daha yüksek 24 saat içinde tamamlama ile ilişkilidir; kanama benzer görünmektedir.

Anahtar Kelimeler

misoprostol , çift balon kateter , ikinci trimester , gebelik termiansyonu , indüksiyon

Destekleyen Kurum

Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Birimi

Proje Numarası

201911A214

Kaynakça

• 1. World Health Organization (WHO). Abortion care guideline. Geneva: WHO; 2022.
• 2. Zwerling M, Koch E, Akers AY, et al. Society of Family Planning clinical recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation. Contraception. 2024;132:110402.
• 3. Toptas T, Mendilcioglu I, Simsek M, Taskin O. Intravaginal misoprostol alone versus intravaginal misoprostol and extra-amniotic Foley catheter for second-trimester pregnancy termination: a randomized clinical trial. Ginekol Pol. 2014;85(8):577-81.
• 4. Kara Ş, Özevin N, Gürel D. İkinci trimester terminasyonda misoprostol tek başına mı, Foley kateter ile birlikte mi? Eur Arch Med Res. 2023;39(4):229-34.
• 5. Goyal V. Uterine rupture in second-trimester misoprostol-induced abortion after cesarean delivery: a systematic review. Obstet Gynecol. 2009;113(5):1117-23.
• 6. Whitehouse K, Kim T, Ganatra B, Blum J. Medical abortion in the second trimester of pregnancy: a systematic review. Contraception X. 2020;2:100037.
• 7. Demirezen G, Aslan Çetin B, Aydoğan Mathyk B, Köroğlu N, Yildirim G. Efficiency of the Foley catheter versus the double balloon catheter during the induction of second trimester pregnancy terminations: a randomized controlled trial. Arch Gynecol Obstet. 2018;298(5):881-7.
• 8. Velipasaoglu M, Ozdemir CY, Ozek B, Ayaz R, Tanir HM. Sequential use of Foley catheter with misoprostol for second trimester pregnancy termination in women with and without caesarean scars: a prospective cohort study. J Matern Fetal Neonatal Med. 2018;31(5):677-81.
• 9. Tu YA, Chen CL, Lai YL, Lin SY, Lee CN. Transcervical double-balloon catheter as an alternative and salvage method for medical termination of pregnancy in midtrimester. Taiwan J Obstet Gynecol. 2017;56(1):77-80.
• 10. Peng J, Li R, Du S, et al. Induction of labour in mid-trimester pregnancy using double-balloon catheter placement within 12 h versus within 12–24 h. BMC Pregnancy Childbirth. 2021;21:17.
• 11. Peel MD, Croll DMR, Kessler J, et al. Double- vs single-balloon catheter for induction of labor: systematic review and individual participant data meta-analysis. Acta Obstet Gynecol Scand. 2023;102(11):1440-9.
• 12. Gemzell-Danielsson K, Lalitkumar S. Second trimester medical abortion with mifepristone-misoprostol and misoprostol alone: a review of methods and management. Reprod Health Matters. 2008;16(31 Suppl):162-72.
• 13. Wildschut H, Both MI, Medema S, Thomee E, Wildhagen MF, Kapp N. Medical methods for mid-trimester termination of pregnancy. Cochrane Database Syst Rev. 2011;(1):CD005216.
• 14. 14. Royal College of Obstetricians and Gynaecologists (RCOG). Best practice in abortion care. London: RCOG; 2022.