Multiple‐dose vaginal misoprostol and single‐dose misoprostol plus oxytocin for termination of second‐trimester pregnancy

Zangeneh, Maryam; Malek-Khosravi, Shohreh; Veisi, Firoozeh; Rezavand, Negin; Rezaee, Mansour; Rajatee, Mozhgan

doi:10.1016/j.ijgo.2011.11.020

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…Zangeneh et al (22) compared two strategies utilizing misoprostol alone and in conjunction with concentrated oxytocin and discovered a more successful way to perform a clinical abortion in the second trimester. Misoprostol and oxytocin appear to be effective and appropriate methods of terminating the pregnancy in the second trimester, according to the researchers.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Misoprostol Safety and Efficacy in Second Trimester Pregnancy Termination in Women with a Previous Cesarean Section

Elela¹

2022

The Egyptian Journal of Hospital Medicine

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Background: In patients who have already undergone a cesarean section, there is increasing use of medications to terminate the pregnancy due to fetal death or fetal anomalies. Objectives: To study the safety and efficacy of pregnancy termination using vaginal misoprostol in women undergone a single lower segment cesarean section. Patients and methods: This clinical trial study included 100 women (attending the Department of Gynecology and Obstetrics, Benha University hospitals) with one previous lower segment cesarean section who were advised to terminate their pregnancy (after 13-26 weeks) due to intrauterine fetal death or fetal structural anomalies. They were divided into two equal groups Group I (cases) who had uterine scars, while Group II (control) without scars. History, clinical examination, and ultrasound imaging were performed on all patients. There were 72 hours in which the patient was given misoprostol every four hours via the vaginal route. Results: It was found that the induction-to-abortion period was much shorter in the control group than in the cases group despite no significant differences in age, parity, gestational age, or doses required to induce abortion between the two groups. There were non-significant differences between patient group I with uterine scar and control group II without uterine scar regarding doses needed, except for 1-4 doses and 9-12 doses which exhibited significant differences. Conclusion:In women who have had a previous cesarean section, the vaginal route of misoprostol in a dose of 50 µg /4 hours is safe and successful for inducing a second-trimester abortion.

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Section: Discussionmentioning

confidence: 99%

Vaginal Misoprostol Safety and Efficacy in Second Trimester Pregnancy Termination in Women with a Previous Cesarean Section

Elela¹

2022

The Egyptian Journal of Hospital Medicine

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“…Zangeneh et al. () studied the use of vaginal misoprostol and vaginal misoprostol combined with intravenous oxytocin and found similar results in the duration from initiation of medications and birth in second trimester pregnancies. The authors recommend both drug regimens to facilitate induction and birth of a second trimester pregnancy, as women in this study experienced few side effects and a short interval between initiation of the medication and vaginal birth (Zangeneh et al., ).…”

Section: Nursing Care During the Intrapartum Periodmentioning

confidence: 91%

Care of the Childbearing Family With Intrauterine Fetal Demise

Sousou¹,

Smart²

2015

Nursing for Women's Health

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“…Dosing regimen of misoprostol for IOL still represents a challenge; Zangeneh et al (13) found combined use of misoprostol with oxytocin gave similar results to the use of multiple doses of misoprostol for 2 nd trimester termination of pregnancy. However, for IOL misoprostol dose-adjustment was not fully evaluated, thus the current study targets to evaluate dose-related outcome of IOL in multipara women so as to determine the appropriate dose for getting trial success defined as having vaginal delivery (VD) within 24-hr induction-to-delivery (ITD) interval.…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%

Misoprostol Induction of Labor in Multipara Pregnant Women: A Mini-Survey for Predictors of Outcome.

MD¹,

MD²

2018

IJAR

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Objectives:To evaluate dose-related outcome of induction of labor (IOL) using misoprostol vaginal inserts (MVI) in multipara pregnant women so as to determine the appropriate dose for getting trial success defined as having vaginal delivery (VD) within 24-hr induction-todelivery (ITD) interval. Patients & Methods: 644 pregnant women underwent clinical evaluation and vaginal examination to determine Bishop score using the Simplified Bishop Score (SBS). All women received 25 µg MVI only once and were monitored for labor progress as judged by SBS and uterine contractions with fetal heart monitoring. In absence of fetal distress manifestations and membranes were still intact, but uterine contractions occurred <3 times/10 minutes, another MVI was used for a maximum of 6 doses. Uterine contraction augmentation was provided as amniotomy or/and oxytocin infusion started 4-hrs after the last MVI was placed. Study outcomes included trail success rate, number of MVI used, frequency and mode of augmentation and delivery assistance. Results: 530 women (82.3%) had VD; 159 women without augmentation, 182 women had amniotomy, 105 women received oxytocin drip and 84 women required both. Only 168 women (26.1%) had instrumentally-assisted VD. Mean ITD interval was 10.9±6.3 hr; 492 women had ITD interval <24 hr for a trial success rate of 76.4%. Cesarean section was indicted in 114 women (17.7%). Only 29 women received four, 71 three, 93 two, while 451 women received one MVI, VD rate was significantly (p<0.00001) lower among women received higher number of MVI. Statistical analyses defined high MVI dose and BMI as negative, while high parity is a positive significant predictor for trial success. High MVI dose and BMI are positive, while high SBS and high parity are negative significant predictors for long ITD interval. Kaplan-Meier regression analysis defined the appropriate MVI for IOL trial success at a mean dose of 1.5±0.039 (95% CI: 1.4-1.55). Conclusion: MVI is a satisfactory modality for IOL trial in multipara pregnant women with VD rate of 82.3% and ITD interval of <24-hr in 76.4%. Lower BMI and higher number of previous VD indicate higher possibility of trial success. SBS is appropriate for women selection for trial and follow-up and can predict outcome if combined with BMI, parity and number of MVI used.

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Multiple‐dose vaginal misoprostol and single‐dose misoprostol plus oxytocin for termination of second‐trimester pregnancy

Abstract: The use of misoprostol with oxytocin, and multiple doses of misoprostol gave similar results for termination of pregnancy in the second trimester.

Cited by 5 publications

References 11 publications

Vaginal Misoprostol Safety and Efficacy in Second Trimester Pregnancy Termination in Women with a Previous Cesarean Section

Vaginal Misoprostol Safety and Efficacy in Second Trimester Pregnancy Termination in Women with a Previous Cesarean Section

Care of the Childbearing Family With Intrauterine Fetal Demise

Misoprostol Induction of Labor in Multipara Pregnant Women: A Mini-Survey for Predictors of Outcome.

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