Abstract
Background
This study was conducted to evaluate and analyze the efficacy and safety of using
gemeprost for second- and third-trimester termination of pregnancy (TOP) in women
with uterine scar due to previous cesarean section.
Study Design
Retrospective analysis of 111 medical TOPs for fetal anomaly or death at 14 to 34
weeks of gestation in women with a history of cesarean section was performed at a
German tertiary care center from 2005 to 2009. Abortion was induced via intravaginal
application of the prostaglandin analogue gemeprost (1 mg) every 6 h.
Results
One hundred eleven women with one (89.2%) or two (10.8%) previous cesarean sections
underwent medical TOP with gemeprost. The median induction-to-expulsion interval was
18 h 24 min (range, 2 h 20 min���168 h 28 min), and in 34 (30.6%) cases, the induction
interval was longer than 24 h. The overall incidence of severe complications was 9/111
(8.1%), including one case of silent uterine rupture (with the need for blood transfusion),
four cases of atonic and three secondary hemorrhages and one case of peritonitis due
to uterine perforation during curettage. Failure of induction (induction-to-expulsion
>48 h) occurred in 11 cases (9.9%).
Conclusion
Gemeprost-induced TOP in the second and third trimester in women with uterine scar
due to previous cesarean section is effective and has a low complication rate.
Keywords
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Article info
Publication history
Published online: November 14, 2011
Accepted:
October 5,
2011
Received in revised form:
October 3,
2011
Received:
June 29,
2011
Footnotes
���The authors report no potential conflicts of interest.
Identification
Copyright
© 2012 Published by Elsevier Inc. All rights reserved.