Comparison of The Efficacy & Safety Of Misoprostol For Termination Of Pregnancy In Second Trimester In Scarred Versus Unscarred Uterus

Abstract

Objectives: To compare the efficacy & safety of Misoprostol for termination of pregnancy in second trimester in scarred versus unscarred uterus. Study Design: Quasi-experimental study. Setting:  Obstetrics & Gynaecology unit of Allied / DHQ Hospitals affiliated with Punjab Medical College, Faisalabad. Subjects & Method: During 6 months period from 22^nd March, 2007 to 22^nd September, 2007. 60 patients (30 with scarred and 30 with unscarred uterus) were admitted for second trimester termination of pregnancy for maternal reason, fetal congenital anomalies and intrauterine fetal demise and induced with vaginal misoprostol. Loading dose of 400 mcg followed by maintenance dose of 200 mcg at 4 hourly interval to a maximum of 4 doses. Main Outcome Measures:  Efficacy included induction to delivery interval & safety included maternal complications and side effects like uterine rupture, hysterectomy, severe haemorrhage, pyrexia, nausea & vomiting. Results:  Success rate of T.O.P. was 96.7% in group A (scarred uterus) VS 93.3% in group B (unscarred uterus) Maternal complications were nausea & vomiting 3.3% in group A VS 0% in group B, Pyrexia 3.3% in each group, no case of uterine rupture was recorded. Conclusion: Misoprostol is safe and effective drug for Midtrimester T.O.P. in scarred as well as unscarred uterus.