Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol

Ting, Wan-Hua; Peng, Fu-Hsiang; Lin, Ho‐Hsiung; Lu, Hsin-Fen; Hsiao, Sheng‐Mou

doi:10.1016/j.tjog.2014.08.008

Cited by 10 publications

(12 citation statements)

References 21 publications

(21 reference statements)

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“…Although previous studies have indicated a correlation between increased interval and CNS abnormalities such as severe hydrocephalus or neural tube defects [25], a recent study by Dickinson did not confirm these associations with the exception of musculoskeletal abnormalities. Similar to the studies by Nesbitt and Giles [25] and Ting et al [26], our results indicate that preterm premature rupture of membranes and CNS abnormalities were associated with a shorter and a longer interval respectively.…”

Section: Discussionsupporting

confidence: 92%

The Utility of Feticide Procedure to Shorten the Induction-to-Abortion Interval in Medical Abortion

Akkurt

Yavuz

et al. 2018

Gynecol Obstet Invest

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Aim: To evaluate the effect of intracardiac potassium chloride feticide procedure (FP) on the induction-to-abortion (I-to-A) interval for various indications in the termination of pregnancy. Method: Medically indicated abortions between 17 and 28 weeks’ gestation were retrospectively evaluated and allocated into 2 groups: Cases with (group 1, n = 58) or without an FP (group 2, n = 60). I-to-A intervals were compared across the groups, considering different baseline parameters and fetal abnormality categories. Results: There were no differences among the groups except in gestational age (GA; mean, 21.2 vs. 19.6 weeks, p = 0.01) in group 1. Overall, the I-to-A interval was shorter (900 ± 233 vs. 1,198 ± 375 min, p = 0.001) and prolonged medical abortion (I-to-A interval > 48 h) was less common (2% vs. 6%, p = 0.03) in group 1. The facilitating effect of FP persisted when indications were categorized as central nervous system, chromosomal, other structural abnormalities, and unclassified conditions. Logistic regression analyses demonstrated the following features to be associated with expulsion of fetus after 24-h: (1) advanced GA (> 24 week; aOR 6.9, 95% CI 3.24–14.72), (2) central nervous system abnormalities (aOR 5.3, 95% CI 2.6–11.4), (3) lack of feticide (aOR 3.67, 95% CI 2.24–10.72). Conclusion: FPs seem to shorten the I-to-A interval and decrease prolonged I-to-A interval rates. This facilitating effect remains unchanged for various medical indications.

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Section: Discussionsupporting

confidence: 92%

The Utility of Feticide Procedure to Shorten the Induction-to-Abortion Interval in Medical Abortion

Akkurt

Yavuz

et al. 2018

Gynecol Obstet Invest

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“…Therefore, it is important to consider the risk of prolonged duration of labor induction in primiparas, and generate solutions as to how to shorten it. In other reports about second‐trimester abortion, higher parity, the presence of IUFD, lower gestational age, and the presence of premature preterm rupture of membranes were significant factors associated with shorter induction‐to‐delivery time . In our study, IUFD and gestational age were not factors that influenced time to delivery of >24 h. This difference is likely due to study design.…”

Section: Discussionsupporting

confidence: 43%

“…In other reports about second-trimester abortion, higher parity, the presence of IUFD, lower gestational age, and the presence of premature preterm rupture of membranes were significant factors associated with shorter induction-todelivery time. [21][22][23] In our study, IUFD and gestational age were not factors that influenced time to delivery of >24 h. This difference is likely due to study design. We excluded the cases with premature preterm rupture of membranes.…”

Section: Discussionmentioning

confidence: 55%

Single versus multiple cervical dilation by osmotic dilator before induction of labor for second‐trimester abortion

Lee

Mimura

Endoh

et al. 2019

J of Obstet and Gynaecol

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Aim In this study, we aimed to investigate whether there was a significant prognostic difference between single and multiple cervical dilations when inducing second‐trimester abortion. Methods We conducted a retrospective review of 238 pregnant women who underwent termination of pregnancy at 12–21 weeks of gestation at Osaka University Hospital in Osaka, Japan, between January 2010 and May 2018. Termination of pregnancy was performed by vaginal administration of 1 mg gemeprost every 3 h for up to five doses per day after uterine cervical dilation using lamicel. Results The women were categorized into two groups: 191 women had a delivery time of <24 h, whereas 47 had delivery times >24 h. Contrasting the groups, there were significant differences with regard to numbers of primiparas (88 [46.1%] and 32 [68.1%], respectively) and lamicel exchanges ± SD (1.9 ± 0.67 for <24 h and 2.4 ± 0.87 for >24 h, respectively). Additionally, we compared the prognosis of primiparas that received just a single lamicel with that of primiparas that had ≥2 exchanged, but no significant differences were noted in the number of patients with a delivery time of >24 h and the number of used gemeprost. Conclusion Primipara is a risk factor for delayed delivery time of induced abortion. However, increasing the number of exchanged lamicel did not significantly reduce the delivery time; therefore, it should be performed as minimally as possible.

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“…A regimen of 200 mg mifepristone and 800 μg buccal or vaginal misoprostol is 95%-98% effective [19]. Various studies have proven its effectiveness [1,[20][21][22][23][24][25][26] and improved health care system [26] in other setting and attributed the declining complication and mortality rates associated with induced abortions in some LMICs countries especially in Latin America to the widespread use of misoprostol [21,23].…”

Section: Introductionmentioning

confidence: 99%

Uptake of Misoprostol among women seeking abortion in Accra, Ghana

Darteh

2020

Preprint

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Background Unsafe abortions remain one of the key contributors to maternal mortality. The World Health Organisation (WHO) has recommended misoprostol as a safe abortifacient which has become a popular over the counter self-administered abortifacient in Ghana. This study sought to examine the prevalence of misoprostol uptake and model the factors associated with its uptake among 698 women seeking abortion services in the Accra Metropolis of Ghana. Methods Univariate and multivariate analysis were done. The multivariate analysis was done using binary logistic regression to model the factors associated with misoprostol uptake and results are presented as adjusted odds ratios (AORs) with their 95% confidence intervals (CIs). P < 0.05 was considered statistically significant. Results The results showed that the prevalence of misoprostol uptake was 20.8%. The regression analysis showed that women who were cohabiting had higher odds [AOR=1.91, CI=1.16-3.16] of using misoprostol compared to women who were single. In relation to miscarriage and use of misoprostol, it was found that women who experienced one [AOR=0.27, CI=0.15-0.49] and 2 or more miscarriages [AOR=0.25, CI=0.07-0.85] had lower odds of using misoprostol compared to those who have never experienced any miscarriage Conclusion The prevalence of misoprostol uptake among women seeking abortion services in Accra Metropolis is relatively high. Marital status and previous history of miscarriage are associated with misoprostol uptake. Although proven effective by various studies and recommended by the WHO, it is imperative to consider these factors in the education of women on the use of misoprostol as well as designing programmes to target women who are inclined to induce abortion in Ghana.

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Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol

Cited by 10 publications

References 21 publications

The Utility of Feticide Procedure to Shorten the Induction-to-Abortion Interval in Medical Abortion

The Utility of Feticide Procedure to Shorten the Induction-to-Abortion Interval in Medical Abortion

Single versus multiple cervical dilation by osmotic dilator before induction of labor for second‐trimester abortion

Uptake of Misoprostol among women seeking abortion in Accra, Ghana

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