Misoprostol for termination of second trimester pregnancy in a scarred uterus

OBJECTIVE: To investigate whether Misoprostol for mid-trimester pregnancy interruption in women with a scarred uterus has any adverse effects compared with those without a scar.

METHODS: During 5-year period from 2000-2004 at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan, a consecutive series of 520 women of 15-28 weeks of gestation who underwent termination of pregnancy were studied. Sixty-three patients had undergone at least previous one cesarean section and 457 served as control. Termination was undertaken using Misoprostol 400 ug vaginally as a starting dose followed by 200 ug vaginally every 6 hours, complications for each group were recorded.

RESULTS: The induction to abortion time was not significantly different in both groups (p=0.16); the median dosage was almost the same (p=0.31). The rate of incomplete abortion was significantly higher in the study group than control 82% versus 60% and 11.5% versus 6.1% for bleeding of more than 500 cc, while the rate of other complications was almost the same.

CONCLUSION: In the second trimester termination of pregnancy, the use of Misoprostol in women with previous single or multiple cesarean sections was not associated with excess complications.