Medical Compared With Surgical Abortion for Effective Pregnancy Termination in the First Trimester

Ireland, Luu Doan; Gatter, Mary; Chen, Angela

doi:10.1097/aog.0000000000000910

Cited by 42 publications

(28 citation statements)

References 18 publications

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“…It is considered safe, particularly in the first trimester, to wait for two weeks after the misoprostol-only regimen and arrange for a follow-up scan. 14 , 19 In this DUE study, the successful medical evacuation rate might have been higher if the patients were given more waiting time before surgical evacuation.…”

Section: Discussionmentioning

confidence: 86%

Misoprostol use in medical evacuation of spontaneous miscarriage: Pilot drug use evaluation study at the Women's Hospital in Qatar

ElSalem

AlSaad

Abdulrouf

et al. 2016

Qatar Medical Journal

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Background: Misoprostol is a synthetic prostaglandin E1 that induces cervical effacement and uterine contractions at all gestational ages, thus facilitating uterine evacuation and pregnancy termination. Successful medical evacuation of spontaneous miscarriage with minimal adverse effects can be performed using misoprostol-only regimen if given as indicated and if the administered dose, frequency of the dosage, and number of total doses are appropriate. Aim: To conduct a drug use evaluation by investigating indications, appropriateness of dosing, and clinical outcome of misoprostol-only regimen when used for medical evacuation of spontaneous miscarriage at the Women's Hospital in Doha, Qatar. Materials and methods: A retrospective descriptive drug use evaluation was conducted on women with spontaneous miscarriage who received misoprostol for medical evacuation during August 2013. The current practice at the Women's Hospital was compared with the recommendation from the World Health Organization (WHO). Patients were stratified into three groups based on weeks of amenorrhea. Results: A total of 107 patients received misoprostol during August 2013, of which 33 (31%) were included in the study. In these patients, the main indication for misoprostol use was missed miscarriage (54.5%). In the group of patients at ≤ 9 weeks of gestation, 80% received an initial dose of 800 μg, 80% received frequency within the WHO recommendation, and the majority had surgical evacuation (80%). In the group of patients at 10–12 weeks of gestation, more than 80% received an initial dose of 800 μg, 6% received frequency within the WHO recommendation, and more than 75% had successful medical evacuation. In the group of patients at 13–22 weeks of gestation, more than 80% received an initial dose of 400 μg, more than 80% received frequency within the WHO recommendation, and 54% had successful medical evacuation. Overall, more than 70% of the patients received ≤ 3 total doses of misoprostol and more than 60% had successful medical evacuation as a clinical outcome. Conclusions: Despite the current practice at the Women's Hospital not always being in accordance with the WHO recommendation, successful medical evacuation was achieved in most patients.

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Section: Discussionmentioning

confidence: 86%

Misoprostol use in medical evacuation of spontaneous miscarriage: Pilot drug use evaluation study at the Women's Hospital in Qatar

ElSalem

AlSaad

Abdulrouf

et al. 2016

Qatar Medical Journal

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“…This risk is higher than the 0.6% risk of unanticipated vacuum aspiration with surgical abortion. 9 Based on these considerations, the European Society of Cardiology has suggested performing a surgical abortion in highest-risk patients, and to limit the dose of misoprostol if it is used. 2 Workup and optimization of the gravida seeking termination is more urgent than for many of the patients for whom the cardiologist may be consulted for perioperative planning.…”

Section: Discussionmentioning

confidence: 99%

Peripartum Cardiomyopathy: Management Strategies for Pregnancy Termination

Darlington

Fleisher

Briller

2020

Women's Health Reports

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Some women have underlying cardiovascular disease that leads to increased morbidity and mortality with pregnancy. These women may choose to terminate a pregnancy rather than face this increased risk. The optimal approach for pregnancy termination in women with cardiomyopathy is not well defined. We present two women with peripartum cardiomyopathy, both modified World Health Organization (mWHO) class IV and with elevated Cardiac Disease in Pregnancy (CARPREG II) pregnancy risk stratification scores who are at the highest risk for pregnancy continuation. Both underwent induced abortion, although the procedure was performed in very different settings. These cases illustrate factors that influence the mode and setting of pregnancy termination performance.

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“…1 Even though surgical evacuation is safer, faster and slightly more effective than medical evacuation, missed abortion is not a surgical emergency. 3 Stopping UFH after abortion without planning for surgery within the next 6 hours to evacuate the conceptus was an absolute iatrogenic error. 2 Hormonal IUD is the best and safest contraception for MVR patients.…”

Section: Descriptionmentioning

confidence: 99%

Video fluoroscopy of an obstructed mechanical replacement valve in pregnancy: an iatrogenic

Mousa

Elkhateb

Gaafar³

2020

BMJ Case Rep

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Medical Compared With Surgical Abortion for Effective Pregnancy Termination in the First Trimester

Abstract: II.

Cited by 42 publications

References 18 publications

Misoprostol use in medical evacuation of spontaneous miscarriage: Pilot drug use evaluation study at the Women's Hospital in Qatar

Misoprostol use in medical evacuation of spontaneous miscarriage: Pilot drug use evaluation study at the Women's Hospital in Qatar

Peripartum Cardiomyopathy: Management Strategies for Pregnancy Termination

Video fluoroscopy of an obstructed mechanical replacement valve in pregnancy: an iatrogenic

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