Which factors influence the number of gemeprost pessaries used in inducing second‐trimester abortions?

Abstract

The course of the abortions was dependent on previous vaginal deliveries and spontaneous abortions.

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

“…The present study investigated the safety and effectiveness of a standard regimen for gemeprost use in a large series of women with a scarred uterus. The 98.4% vaginal delivery rate achieved in these women, which was similar to the rate for the control group (98.6%), is in agreement with other reports on the use of gemeprost [7,11], or other drugs [13], in women with a scarred uterus. In this study the standard regimen for gemeprost treatment was used, 1 dose every 3 h up to 5 doses over 24 h. After the first complete cycle, a 24‐h interval was observed before initiating a second cycle of gemeprost treatment, at the same dosage.…”

“…It should be stressed that, in the present series, all women with a history of uterine surgery were nulliparas, although this was not an inclusion criterion. In multiparas the number of previous vaginal deliveries was the main variable responsible for the clinical response to gemeprost, as was observed in previous studies [7,15]. The number of previous induced abortions correlated with the number of pessaries needed, and the induction to abortion interval correlated only in nulliparas with an unscarred uterus, not in women with previous vaginal deliveries or in women with a scarred uterus.…”

“…Three to 5 doses are administered as vaginal pessaries, usually at 3‐ to 6‐h intervals [4–7], over 24 h [3,7,8]. Although this method is effective for second‐trimester abortion, with a success rate higher than 95% [3,7,9–11], terminating a pregnancy in a woman with a uterine scar is always challenging and it has been suggested that the standard drug regimen ought to be modified in such cases [3]. However, there are few data on the effectiveness and safety of the use of intravaginal prostaglandin analogues in women with a history of 1 or more cesarean sections (CSs) or myomectomy.…”