Combined use of intracervical foley catheter and vaginal misoprostol for termination of second trimester pregnancy: a three-year observational study

Abstract

Objectives: To assess the effectiveness, safety and acceptability of intracervical foley catheter and vaginal misoprostol versus vaginal misoprostol for termination of second trimester pregnancy. Methods:This clinical study was conducted on 200 pregnant patients intended for termination of pregnancy between 13-24 gestational weeks for any indication. Enrolled women were equally allocated into two groups:Group I (Misoprostol group): a standard regimen of moistened misoprostol tablets (400 μg) 4 hourly inserted vaginally. Group II (Combined group):intracervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (400 μg) 4 hourly intravaginally was used.Procedure efficacy (defined as complete abortion performed on site), safety and acceptability were assessed. Results:The induction to abortion interval was 8.16 ± 1.52 hours in the combined group compared to 12.76 ± 1.63 hours in the misoprostol group (P value<0.001) with success rate of 96% in the combined group and no major complications reported. Conclusions:Combined use of intracervical foley catheter and vaginal misoprostol is a novel safe, effective and acceptable method for termination of second trimester pregnancy. Synopsis: Combined use of intracervical foley catheter and vaginal misoprostol is a novel safe, effective and acceptable method for termination of second trimester pregnancy.

Comparative study of combination of misoprostol with Foley’s bulb compared with misoprostol alone for termination of second trimester pregnancy

“…We observed mean age as 27.12±4.5 years that shows most of women having an abortion are between age of 20-30 years which is similar as found by Rezk et al and Mahajan et al 13,14 Out of 100 cases in our study, 39 cases required misoprostol dose 600 mcg and showed the maximum abortion rate within 24 hours. It suggests that 600 mcg misoprostol dose is required in maximum number of patients with high rate of abortion success.…”

“…In our study, none of the cases reported uterine rupture in both groups which is similar to the study of Rezk et al current study showed that 4% cases reported complications in combined misoprostol and Foley catheter group and 10% cases reported complications in misoprostol alone group in termination of second trimester pregnancy. 13 These findings were compared to studies of Rezk et al and Samantaray et al 13,22 According to them, there was significant difference in two groups in terms of complications but the sample size was not enough for a conclusion. The most common complication seen in our study is excessive bleeding per vagina followed by need of blood transfusion.…”

“…In our study, none of the cases reported to have uterine rupture which is similar to the study by Rezk et al only 7% cases reported complications by the use of misoprostol. 13 It suggests that misoprostol can be used for the termination of second trimester pregnancy. Data which we found in our observational study were almost similar as shown by Jamali et al study where 13.2% cases reported complications.…”

“…Results were compared with Rezk et al study which showed that side effects were comparable in both the groups which comprised of severe abdominal pain, fever with chills and diarrhea. 13 Thus it was observed that Treatment by misoprostol during the second and third trimesters makes it possible to terminate a pregnancy easily and quickly without significant side effects.…”

Induction of labour in pregnancies with fetal demise: a randomised control trial

“…Similar findings were observed by Rezk et al in 2015. 14 Pain, nausea and vomiting were more common in Group A, present in 100% and 12% respectively in Group A. Pain, nausea and vomiting were present in 100%, and 10% respectively in Group B.…”