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Midtrimester abortion in patients with a previous uterine scar
Abraham Debby1, Abraham Golan, Ron Sagiv
1Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon 58100, Israel.
Objective:
To investigate whether extraamniotic prostaglandin E2 (PGE2) for midtrimester pregnancy interruption in women with a scarred uterus has any adverse effects compared to those without an uterine scar.
Study Design:
Two hundred and sixty-two women who underwent second trimester (16-27 gestational weeks) termination of pregnancy were enrolled in this study. Thirty-one women with a uterine scar were compared with 231 patients without a scarred uterus. Extraamniotic PGE2 was applied in serial doses of 200 mcg every 2 h up to 20 doses. Intravenous infusion of oxytocin was added in cases when the fetus was not expelled. Curettage was performed in the majority of the patients.
Results:
The two groups were similar for indications for pregnancy termination, maternal age and gestational age. Gravidity and parity were significantly higher in the group with an uterine scar. The mean induction to abortion time and the complication rate were similar in both groups. No uterine rupture was observed.
Conclusion:
Extraamniotic PGE2 for midtrimester termination of pregnancy is a safe procedure with a low complication rate, even in patients with an uterine scar.