Intravaginal gemeprost and second‐trimester pregnancy termination in the scarred uterus

Marinoni, Emanuela; Santoro, Marta; Vitagliano, M.P.; Patella, Alfredo; Cosmi, E.V.; Iorio, Raffaele

doi:10.1016/j.ijgo.2006.12.013

Cited by 20 publications

(15 citation statements)

References 15 publications

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“…Some studies have reported on the use of gemeprost with or without laminaria for TOP during the second trimester 3,6,9,11,12 . The mean total dose of gemeprost used in this study (previous CS group, 2.8 ± 1.4 mg; control group; 2.4 ± 1.6 mg) was remarkably lower than the doses used in the previous studies wherein gemeprost was used without laminaria 9,11 .…”

Section: Discussioncontrasting

confidence: 64%

“…It has recently been reported that TOP by administration of gemeprost alone can be performed as safely in patients with uterine scars as in those without scars 9–11 . Although no difference was observed in the incidence of major complications between patients with and without scars, two cases of uterine rupture were observed among the patients with uterine scars (1.5%) 11 …”

Section: Introductionmentioning

confidence: 94%

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Midtrimester termination of pregnancy using gemeprost in combination with laminaria in women who have previously undergone cesarean section

Obata‐Yasuoka

Hamada

Watanabe³

et al. 2009

J of Obstet and Gynaecol

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Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 94%

Midtrimester termination of pregnancy using gemeprost in combination with laminaria in women who have previously undergone cesarean section

Obata‐Yasuoka

Hamada

Watanabe³

et al. 2009

J of Obstet and Gynaecol

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“…The mortality and morbidity of the second trimester is greater than that of the first trimester termination. Abortion-related morbidity and mortality increase significantly as pregnancy advances with a sharp rise in the rate of severe complications in induced abortion after 14 weeks of pregnancy [9, 10]. Women present with varying reasons for the delay in presenting, being logistical, social, or economic.…”

Section: Discussionmentioning

confidence: 99%

Silent Uterine Rupture with the Use of Misoprostol for Second Trimester Termination of Pregnancy : A Case Report

Torriente¹

2011

Obstetrics and Gynecology International

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Uterine rupture is an uncommon, but a life-threatening, complication following second trimester medical termination of pregnancy (TOP). The reported cases have been in both the scarred and unscarred uterus (Rajesh et al. 2002, Drey et al. 2006, and Dickinson). A 27-year-old with two previous deliveries, no previous caesarean section, no history of induced abortions, and no gynaecological operations. She presented with amenorrhoea, and according to her last normal menstruation, she was 10 weeks and 5 days. Ultrasound was done, and it reported 16 weeks and 5 days. She asked for TOP. According to the clinic's protocol, misoprostol 800 mcg (4 tabs) were given to be used vaginally as a loading dose and another three to be taken orally after that. In the following day when she attended the clinic for follow up, a manual vacuum aspiration (MVA). A manual vacuum aspiration was indicated as an incomplete abortion. During the procedure, a uterine rupture was found in the uterine lower segment. A laparotomy was done and a lineal uterine rupture was found and sutured. The patient had a good postoperative recovery and was discharged from hospital after four days. The clinician dealing with second trimester terminations should be aware of the possibility of having a uterine rupture, especially in patients with a uterine scar in order to make an early diagnosis.

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“…One patient at 20 weeks pregnancy with two lower-segment transverse caesarean sections required hysterotomy due to uncontrolled vaginal bleeding and hysterectomy during the procedures due to unresponsive uterine atony. 68 A small case series of 15 women with one to two prior low transverse caesarean deliveries having second trimester abortion between gestations of 16 and 28 weeks revealed no uterine rupture without specifically describing the regimen. There was one uterine rupture among the two women with previous classical caesarean deliveries.…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

Issues in second trimester induced abortion (medical/surgical methods)

Lee

2010

Best Practice & Research Clinical Obstetrics & Gynaecol

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Second trimester abortion remains a common procedure worldwide. Dilatation and evacuation (D&E) is the surgical method of choice, if the surgical expertise and facilities are available. Adequate cervical dilatation preoperatively is a prerequisite for a safe D&E. Medical abortion using misoprostol together with mifepristone is the medical method of choice. The recommended regimen is 200mg mifepristone followed by 800 microg of vaginal misoprostol 36-48 h later. Subsequent doses of 400 microg of misoprostol can be given orally every 3h up to a maximum of four more doses. Proper preoperative assessment would not only help to provide safe abortion treatment, but it also guides the choice of method. If the expertise and facilities of both methods are available, both methods should be discussed and offered to the patient so that the patient can make an informed choice.

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Intravaginal gemeprost and second‐trimester pregnancy termination in the scarred uterus

Abstract: The rate of complications following intravaginal administration of a PGE(1) analogue for second-trimester pregnancy termination was similar in women with a scarred or unscarred uterus.

Cited by 20 publications

References 15 publications

Midtrimester termination of pregnancy using gemeprost in combination with laminaria in women who have previously undergone cesarean section

Midtrimester termination of pregnancy using gemeprost in combination with laminaria in women who have previously undergone cesarean section

Silent Uterine Rupture with the Use of Misoprostol for Second Trimester Termination of Pregnancy : A Case Report

Issues in second trimester induced abortion (medical/surgical methods)

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