A comparative study of three methods (pharmacological, mechanical and combined pharmacological and mechanical) for indicated termination of pregnancy in 2nd trimester pregnancy in women with previous caesarean section scared uterus

Document Type : Original Article

Authors

1 Obstetrics and Gynecology, faculty of medicine, Minia university, Minia, Egypt

2 Department of Obstetrics & Gynecology, Minia University- Faculty of Medicine.

3 Department of Obstetrics & Gynecology, Minia University- Faculty of Medicine.

4 Obstetric and gynaecology, faculty of medicine, minia university

Abstract

Objective:To evaluate efficacy of three regimens for termination of second trimester pregnancy in women with previous caesarean section.

Patients and Methods:Clinical comparative experiment was carried out at the prenatal and fetomaternal clinics in the obstetrics & gynecology department of Minia maternity & children University hospital.102 pregnant women in good health,between 14 and 28 weeks pregnant,who had previously had one or more cesarean births and were diagnosed with missed abortion or intrauterine fetal death.And classified into three Groups Group 1 (G-1) vaginal or sublingual misoprostol,Depending on pregenancy duration.Group 2 (G-2) Foley's catheter Insertion,which was then filled with normal saline.Group 3 (G-3) combined misoprostol and Foley's catheter.The primary outcome was (IAI),together with the (standard deviation) needed for full uterine evacuation.

Results:No statistically significant disparity (p > 0.05) in the patients' characteristics and baseline data among the three groups.Notable disparity among the three groups regarding IAl.[G-3] had the shortest length,[G-1] had the greatest duration,and [G-2] had an intermediate duration (32.5 +10.9,43.1 ± 17.5, and 36.7 ± 14.8, respectively) (P< 0.013).The success rate was 100% for Group 3, 97.05% for Group 1,and 88.2% for Group 2 (p < 0.03).A significant discrepancy regarding fever,with the highest number of cases (12) recorded in G-1.Hysterotomy needed among G-1,one cases,G-2cases.

Conclusion:The concurrent administration of misoprostol and Foley's catheter for the purpose of medically terminating a pregnancy in the second trimester,specifically in women with a previous caesarean section and a uterus that is prone to scarring,has been determined to be more efficacious and secure compared to other methods.

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Minia Journal of Medical Research

Articles in Press, Accepted Manuscript
Available Online from 13 February 2024

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