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Abstract：
OBJECTIVE: To compare the outcomes of termination of pregnancy with live fetuses in the second trimester (14-28 weeks), using misoprostol 400 mcg intravaginal every 6 h, between women with previous cesarean section (PCS) and no previous cesarean section (no PCS).
METHODS: A comparative study was conducted on a prospective database of pregnancy termination in the second trimester, Chiang Mai university hospital. Inclusion criteria included: (1) singleton pregnancy; (2) gestational age between 14 and 28 weeks; and (3) pregnancy with a live fetus and medically indicated for termination. The participants were categorized into two groups; PCS and no PCS group. All were terminated using misoprostol 400 mcg intravaginal every 6 h. The main outcomes were induction to fetal delivery interval and success rate, defined as fetal delivery within 48 h.
RESULTS: A total of 238 women, including 80 PCS and 158 no PCS, were recruited. The success rate of fetal delivery within 48 h between both groups was not significantly different (91.3% vs. 93.0%; p-value 0.622). The induction to fetal delivery interval were not significantly different (1531 vs. 1279 min; p-value > 0.05). Gestational age was an independent factor for the success rate and required dosage of misoprostol. The rates of most adverse effects of misoprostol were similar. One case (1.3%) in the PCS group developed uterine rupture during termination, ending up with safe and successful surgical removal and uterine repair.
CONCLUSIONS: Intravaginal misoprostol is highly effective for second trimester termination of pregnancy with PCS and those with no PCS, with similar success rate and induction to fetal delivery interval. Gestational age was an independent factor for the success rate and required dosage of misoprostol. Uterine rupture could occur in 1.3% of PCS, implying that high precaution must be taken for early detection and proper management.
CONCLUSIONS: Intravaginal misoprostol is highly effective for termination of second trimester pregnancy with a live fetus, with a comparable success rate between women with and without previous cesarean section, with a 1.3% risk of uterine rupture among women with previous cesarean section.
METHODS: A comparative study was conducted on a prospective database of pregnancy termination in the second trimester, Chiang Mai university hospital. Inclusion criteria included: (1) singleton pregnancy; (2) gestational age between 14 and 28 weeks; and (3) pregnancy with a live fetus and medically indicated for termination. The participants were categorized into two groups; PCS and no PCS group. All were terminated using misoprostol 400 mcg intravaginal every 6 h. The main outcomes were induction to fetal delivery interval and success rate, defined as fetal delivery within 48 h.
RESULTS: A total of 238 women, including 80 PCS and 158 no PCS, were recruited. The success rate of fetal delivery within 48 h between both groups was not significantly different (91.3% vs. 93.0%; p-value 0.622). The induction to fetal delivery interval were not significantly different (1531 vs. 1279 min; p-value > 0.05). Gestational age was an independent factor for the success rate and required dosage of misoprostol. The rates of most adverse effects of misoprostol were similar. One case (1.3%) in the PCS group developed uterine rupture during termination, ending up with safe and successful surgical removal and uterine repair.
CONCLUSIONS: Intravaginal misoprostol is highly effective for second trimester termination of pregnancy with PCS and those with no PCS, with similar success rate and induction to fetal delivery interval. Gestational age was an independent factor for the success rate and required dosage of misoprostol. Uterine rupture could occur in 1.3% of PCS, implying that high precaution must be taken for early detection and proper management.
CONCLUSIONS: Intravaginal misoprostol is highly effective for termination of second trimester pregnancy with a live fetus, with a comparable success rate between women with and without previous cesarean section, with a 1.3% risk of uterine rupture among women with previous cesarean section.
摘要：
目的：比较妊娠中期（14-28周）与活胎终止妊娠的结局，使用米索前列醇400微克阴道内每6小时，既往剖宫产（PCS）和未剖宫产（无PCS）的妇女之间。
方法：对妊娠中期终止妊娠的前瞻性数据库进行了比较研究，清迈大学医院。纳入标准包括：（1）单胎妊娠；（2）胎龄在14至28周之间；（3）有活胎儿并经医学指示终止妊娠。参与者分为两组;PCS组和无PCS组。所有患者均每6h阴道内使用米索前列醇400mcg终止。主要结局是诱导胎儿分娩间隔和成功率。定义为48小时内胎儿分娩。
结果：共有238名妇女，包括80PCS和158没有PCS，被招募。两组48h内胎儿分娩成功率无显著差异(91.3%vs.93.0%；p值0.622）。胎儿分娩的诱导间隔没有显着差异（1531vs.1279分钟；p值>0.05)。妊娠年龄是成功率和所需米索前列醇剂量的独立因素。米索前列醇的大多数不良反应发生率相似。PCS组有1例(1.3%)在终止妊娠时出现子宫破裂,最终安全成功的手术切除和子宫修复。
结论：米索前列醇对有PCS和无PCS的中期妊娠终止非常有效，成功率和引产间隔相似。妊娠年龄是成功率和所需米索前列醇剂量的独立因素。1.3％的PCS可发生子宫破裂，这意味着必须采取高度预防措施，以便及早发现和适当管理。
结论：米索前列醇对终止活胎儿中期妊娠非常有效，有和没有剖宫产的妇女的成功率相当，在先前剖宫产的妇女中，子宫破裂的风险为1.3%。
方法：对妊娠中期终止妊娠的前瞻性数据库进行了比较研究，清迈大学医院。纳入标准包括：（1）单胎妊娠；（2）胎龄在14至28周之间；（3）有活胎儿并经医学指示终止妊娠。参与者分为两组;PCS组和无PCS组。所有患者均每6h阴道内使用米索前列醇400mcg终止。主要结局是诱导胎儿分娩间隔和成功率。定义为48小时内胎儿分娩。
结果：共有238名妇女，包括80PCS和158没有PCS，被招募。两组48h内胎儿分娩成功率无显著差异(91.3%vs.93.0%；p值0.622）。胎儿分娩的诱导间隔没有显着差异（1531vs.1279分钟；p值>0.05)。妊娠年龄是成功率和所需米索前列醇剂量的独立因素。米索前列醇的大多数不良反应发生率相似。PCS组有1例(1.3%)在终止妊娠时出现子宫破裂,最终安全成功的手术切除和子宫修复。
结论：米索前列醇对有PCS和无PCS的中期妊娠终止非常有效，成功率和引产间隔相似。妊娠年龄是成功率和所需米索前列醇剂量的独立因素。1.3％的PCS可发生子宫破裂，这意味着必须采取高度预防措施，以便及早发现和适当管理。
结论：米索前列醇对终止活胎儿中期妊娠非常有效，有和没有剖宫产的妇女的成功率相当，在先前剖宫产的妇女中，子宫破裂的风险为1.3%。
