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

Obata‐Yasuoka, Mana; Hamada, Hiromi; Watanabe, Hideki; Shimura, Rena; Toyoda, Maki; Yagi, Hiroya; Takeshima, Kinuko; Abe, Kiyoshi; Nakamura, Yoshiko; Ogura, Tsuyoshi; Fujiki, Yutaka; Yoshikawa, Hiroyuki

doi:10.1111/j.1447-0756.2009.01044.x

Cited by 8 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laminaria (Lam) most likely acts by absorbing water from proteoglycan complexes, and by breaking down these complexes, it softens and dilates the cervix. Also, since Lam is extracted from natural sources, it has few complications (18).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Behnoud

Noori

Ghasemi

et al. 2022

Zahedan J Res Med Sci

View full text Add to dashboard Cite

Background: Therapeutic abortion in the second trimester of pregnancy is the treatment of choice in cases such as severe anomalies or fetal death, and both medical and mechanical methods are used to prepare the cervix. One of the various medical methods is the use of misoprostol (Miso) and one of the various mechanical methods is the use of laminaria (Lam). Objectives: This study aimed to compare the use of Miso alone and its combination with Lam in therapeutic abortion in the second trimester of pregnancy. Methods: In this clinical trial study, pregnant women between 14 and 20 weeks of gestation who were admitted to Ali-Ibn Abitaleb Hospital in Zahedan from July 2019 to September 2020 and were candidates for pregnancy termination due to severe anomalies or fetal death were investigated. After obtaining consent, patients were randomly divided into two groups of 45 receiving Miso alone and Miso + Lam. Then, in addition to demographic variables, the number of hospitalization days, the need for curettage, blood transfusions, analgesics, and the symptoms and complications of drugs were investigated. Results: In this study, none of the demographic factors were significantly different between the two groups (P > 0.05). However, the need for curettage (P = 0.05), labor time (P = 0.04), and hospitalization days (P = 0.003) in the Miso + Lam group were less than the group of Miso alone. Conclusions: Our results showed that curettage cases, labor duration, and length of hospital stay decreased in the Miso + Lam group.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Behnoud

Noori

Ghasemi

et al. 2022

Zahedan J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…Although less frequently observed during secondtrimester-induced labor, there is a risk of massive bleeding, uterine rupture and infection, particularly in patients with histories of previous cesarean sections or pregnancy complications, for which vaginal delivery is commonly performed. 7,8 Although it is preferable to complete the induced abortion as safely and quickly as possible, it is still uncertain in which cases the delivery time is prolonged. It is controversial that delivery time is shortened by the combined use of osmotic dilation during second-trimester-induced abortions.…”

Section: Introductionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

Uterine rupture following prostaglandins use in second trimester medical abortion: Fact or fiction? A systematic review

Malvasi,

Tinelli,

Mulone

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundProstaglandins (PGs) have emerged as key drugs in second trimester medical abortion (STMA) and are currently a cornerstone in obstetric practice. Nevertheless, the application of PGs, integral to labor and abortion procedures, is not risk‐free, and has been associated with several complications, particularly maternal fever and uterine rupture (UR).ObjectivesThe main outcome of the present systematic review was to assess the safety of PGs use in STMA, particularly in scarred uterus (SC).Search StrategyThe review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. We performed a comprehensive systematic review by searching multiple databases, including MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database, and the research registers of Web of Science during the years 1990–2022.Selection CriteriaOnly articles regarding cases of UR occurred after the use of PGs for STMA were included in the article. We excluded papers regarding UR during first trimester abortion induction of labor or pregnancy or unrelated to PGs use for STMA. Risk of bias was assessed employing a modified version of the “Newcastle‐Ottawa Scale” (NOS).Data Collection and AnalysisA total of 178 studies were initially identified as potentially meeting the criteria for inclusion in the review. After full text evaluation, 110 other articles were excluded and 67 studies that suited the inclusion criteria were included. A total of 19 of the included studies were judged to have a high risk of bias. Given the heterogeneous nature of the findings, we opted for a narrative synthesis of the results.Main Results and ConclusionsPGs appear to be an effective pharmacologic tool for STMA; however, their use is not entirely risk‐free. STMA requires well‐equipped obstetric centers with skilled clinicians and surgeons prepared for emergencies. Ultrasonographic scans should be routinely performed during STMA management, since a UR can also be silent during the induction of labor. Intrapartum transabdominal, transperineal, and transvaginal ultrasound may have the diagnostic potential to early recognize this obstetric emergency, to facilitate rapid medical and surgical treatment, improving the outcome.

show abstract

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

Abstract: The efficacy and safety of our laminaria-gemeprost protocol for termination of pregnancy during the midtrimester are similar for women who have previously undergone cesarean section and those who have not.

Cited by 8 publications

References 15 publications

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

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

Uterine rupture following prostaglandins use in second trimester medical abortion: Fact or fiction? A systematic review

Contact Info

Product

Resources

About