Misoprostol for termination of second trimester pregnancy in a scarred uterus

To investigate whether Misoprostol for mid-trimester pregnancy interruption in women with a scarred uterus has any adverse effects compared with those without a scar.

During 5-year period from 2000-2004 at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan, a consecutive series of 520 women of 15-28 weeks of gestation who underwent termination of pregnancy were studied. Sixty-three patients had undergone at least previous one cesarean section and 457 served as control. Termination was undertaken using Misoprostol 400 ug vaginally as a starting dose followed by 200 ug vaginally every 6 hours, complications for each group were recorded.

The induction to abortion time was not significantly different in both groups (p=0.16); the median dosage was almost the same (p=0.31). The rate of incomplete abortion was significantly higher in the study group than control 82% versus 60% and 11.5% versus 6.1% for bleeding of more than 500 cc, while the rate of other complications was almost the same.

In the second trimester termination of pregnancy, the use of Misoprostol in women with previous single or multiple cesarean sections was not associated with excess complications.