Misoprostol for second and third trimester termination of pregnancy: A review of practice at the Women's and Children's Hospital, Adelaide, Australia

Abstract

Side-effects increase with increasing dose of misoprostol. Induction following intrauterine fetal death is associated with a need for lower doses of misoprostol and a shorter induction to birth interval.

Clinical efficacy of mifepristone and misoprostol in second trimester pregnancy termination

“…As multiparous women and women with shorter gestation were more likely to complete the termination faster, they required less prostaglandin. This trend of decreased need of prostaglandin in multiparous women has also been recognized by Dodd et al (30); lower gestational age may also function as a predictor of shorter induction-to-abortion time (11).…”

“…The median age of the women was 28 years . The women's body mass index (BMI) median was 23 kg/m 2 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Seven (7.8%) women were obese (BMI >30 kg/m 2 ).…”

Medical abortion: the Australian experience

“…Misoprostol 400 µg vaginally at 6-h intervals was considered to be the preferred regime in WA. All studies noted an increased incidence of side effects with increased misoprostol dosage; the main side effects were gastrointestinal, in particular vomiting [25][26][27][28]. There was a significant incidence of retained placenta following misoprostol abortion, as was the case with gemeprost-induced abortion, and this is also the clinical experience following spontaneous secondtrimester miscarriage.…”

“…Second-and third-trimester abortion in Australia over the past two decades has largely been medical rather than surgical; dilatation and extraction and hysterotomy are relatively uncommon. Several large studies and reviews have confirmed the efficacy of misoprostol for late abortion, including a study of 199 women in SA and another of 219 women from WA [25][26][27][28]. Misoprostol 400 µg vaginally at 6-h intervals was considered to be the preferred regime in WA.…”

“…During the 1990s, Australian practitioners gradually switched from gemeprost to misoprostol for the purpose of second-and third-trimester termination of pregnancy, both in cases where intra-uterine fetal death had occurred and in situations where the fetus, if born alive, would not survive or would have a severe and permanent handicap [12,[25][26][27][28]. Misoprostol was found to be cheaper and the compound is more stable than gemeprost.…”