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KMID : 1143220200630030323
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Obstetrics & Gynecology Science
2020 Volume.63 No. 3 p.323 ~ p.329
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Misoprostol complications in second-trimester termination of pregnancy among women with a history of more than one cesarean section
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Jamali Marzieh
Bakhtiyari Mahmood
Arab Fatemeh
Mirzamoradi Masoumeh
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Abstract
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Objective: This study aims to investigate the complications due to misoprostol administration for second-trimester termination of pregnancy among women with history of 2 or more cesarean scarring.
Methods: The cohort of this retrospective study included 678 subjects who required second-trimester pregnancy termination, from 2013 to 2015 and treated with vaginal misoprostol of 100 to 400 μg. The subjects were divided into 3 groups based on their history of cesarean sections: without a history of cesarean section, with a history of one cesarean section, and with a history of more than one cesarean section and uterine scaring.
Results: The results showed that the success rate of misoprostol administration for pregnancy termination was 95.72%. The rate of bleeding as a complication was significantly higher in subjects with a history of more than one cesarean section than in other participants (risk ratio [RR], 2.24; 95% confidence interval [CI], 1.11?4.0). The incidence of uterine rupture was higher in the group with a history of more than one cesarean section than in other groups. However, no significant difference was observed between the groups (RR, 1.44; 95% CI, 0.27?7.6). There was a significant relationship between the need for other auxiliary treatments in the pregnancy termination and the history of uterine scarring (RR, 3.3; 95% CI, 1.23?9.1).
Conclusion: The present study showed that pregnancy termination using smaller divided dose of misoprostol in patients with previous history of cesarean scarring may be associated with lower incidence of uterine rupture.
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KEYWORD
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Misoprostol, Cesarean section, Pregnancy complications
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