ABORTION IN THE SECOND TRIMESTER OF PREGNANCY
DOI:
https://doi.org/10.54890/.v2i2.1340Abstract
Medical abortion has revolutionized access to quality abortion services in obstetrics and gynecology. However, the issues of termination in the second trimester of pregnancy in women with a uterine scar still remain controversial. The urgency of the problem is associated with such a serious obstetric complication as uterine rupture along the scar. Objective. To evaluate the effectiveness and safety of medical abortion in patients at 18-22 weeks of pregnancy. Materials and methods. A prospective cohort study was conducted without blinding (pregnant women and doctors knew which method was used to terminate the pregnancy). 15 patients were included in the gestational age of 18-22 weeks, including 7 with a uterine scar after a previous cesarean section. For the purpose of medical termination of pregnancy, a combination of mifepristone and misoprostol was used. A clinical and statistical assessment of the obtained data was carried out. Results. The total duration of abortion after taking misoprostol was on average 9.5 (95% CI 8.346-10.168) hours and did not differ in the group of pregnant women with a uterine scar - 9.8 (95% CI 9.346-10.202) hours and without a uterine scar - 9.6 (95% CI 9.356-10.217) hours (p>0.05). The volume of blood loss was in the range of 180.0 (95% CI 150.0–200.0) ml. A positive effect was achieved in 100% of cases. Pathology associated with the separation of the placenta was identified in 2 (13.3%) cases in the presence of a scar on the uterus after cesarean section. Conclusion. The presence of a previous uterine scar after cesarean section did not affect the duration of abortion. In most cases, for successful termination of pregnancy at 18-22 weeks, the maximum dose of oral misoprostol was 1200 mcg.
Keywords:
abortion in the second trimester of pregnancy, cesarean section, mifepristone, misoprostol, congenital fetal growth, preconception preparation.References
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