How to manage unresponsiveness to misoprostol in failed second trimester pregnancy termination

Pongsatha, Saipin; Tongsong, Theera

doi:10.1111/j.1447-0756.2012.01911.x

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…In women with > 1 previous uterine surgery including myomectomy and/or cesarean delivery, all doses were reduced by 50% to 1,000 μg/24 h. We monitored patients every 4 h, and maternal side effects were recorded. If abortion was not complete within 48 h (prolonged abortion), an intracervical Foley catheter inflated with 30-50 mL of normal saline was administered in addition to repeat misoprostol regimen [13]. The time period between first misoprostol admission and expulsion of fetus was identified as I-to-A interval.…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

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

Akkurt

Yavuz

et al. 2018

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

How to manage unresponsiveness to misoprostol in failed second trimester pregnancy termination

Abstract: Failure of pregnancy termination using misoprostol can be successfully managed by introducing additional misoprostol, modified condom balloon technique and oxytocin infusion. These methods should be considered before proceeding to hysterotomy.

Cited by 1 publication

References 15 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

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