(2024). Reduced Misoprostol Regimen versus Standard Misoprostol Regimen for Induction of Second Trimester Abortion in Patients with Previous Cesarean Section Scar. The Egyptian Journal of Hospital Medicine, 97(1), 3442-3447. doi: 10.21608/ejhm.2024.384070
. "Reduced Misoprostol Regimen versus Standard Misoprostol Regimen for Induction of Second Trimester Abortion in Patients with Previous Cesarean Section Scar". The Egyptian Journal of Hospital Medicine, 97, 1, 2024, 3442-3447. doi: 10.21608/ejhm.2024.384070
(2024). 'Reduced Misoprostol Regimen versus Standard Misoprostol Regimen for Induction of Second Trimester Abortion in Patients with Previous Cesarean Section Scar', The Egyptian Journal of Hospital Medicine, 97(1), pp. 3442-3447. doi: 10.21608/ejhm.2024.384070
Reduced Misoprostol Regimen versus Standard Misoprostol Regimen for Induction of Second Trimester Abortion in Patients with Previous Cesarean Section Scar. The Egyptian Journal of Hospital Medicine, 2024; 97(1): 3442-3447. doi: 10.21608/ejhm.2024.384070
Reduced Misoprostol Regimen versus Standard Misoprostol Regimen for Induction of Second Trimester Abortion in Patients with Previous Cesarean Section Scar
Background: There has been a debate concerning the use of misoprostol for mid-trimester (13-26 weeks) pregnancy termination in women with prior cesarean scars due to concerns regarding a potential higher risk of uterine rupture. Objectives: To evaluate the efficacy and safety of two misoprostol regimens (400 mcg misoprostol versus 200 mcg misoprostol) for 2nd-trimester pregnancy termination in individuals with a prior cesarean section scar. Patients and methods: A prospective randomized study included one hundred and seventy-six patients at 13-26 weeks gestation with previous one cesarean section who were scheduled for pregnancy termination using misoprostol. Participants were randomly divided into two equal groups. Group A (standard misoprostol regimen, 88 patients) received 400 mcg of misoprostol vaginally every 4 hours until the fetus was expelled, and Group B (reduced misoprostol regimen, 88 patients) received 200 mcg of misoprostol vaginally every 4 hours until the fetus was expelled. Primary outcomes were time to abortion and complete abortion rates, secondary outcomes were side effect and complications. Results: There was no significant difference between the two groups regarding demographic data. The only documented advantage of standard misoprostol regimen in the current study was significantly shorter induction-abortion interval (28.26 ±2.52 hours) versus 36.6±2.16 hours in reduced misoprostol group. However, reduced misoprostol regimen has comparable complete abortion rates to standard misoprostol regimen with no significant difference (75% and 84.1% respectively, p=0.13). Additionally, there were no significant differences between groups regarding the need of curettage for incomplete abortion. Conclusion: Low-dose vaginal misoprostol administration seems to be beneficial for terminating a 2nd-trimester pregnancy in women with a prior cesarean scar without causing side effects or complications.
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