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Second trimester abortion using intravaginal misoprostol
Y Herabutya1, P O-Prasertsawat
1Department of Obstetrics and Gynaecology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Summary
The 600-microg dose of intravaginal misoprostol is most effective for second-trimester abortions, achieving a 96% success rate. While side effects like nausea and diarrhea increased, they were mild and manageable.
Area of Science:
- Reproductive Medicine
- Pharmacology
Background:
- Second-trimester abortions require effective and safe induction methods.
- Intravaginal misoprostol is a widely used agent for pregnancy termination.
Purpose of the Study:
- To determine the optimal effective dose of intravaginal misoprostol for inducing second-trimester abortions.
- To evaluate the efficacy and safety of different misoprostol dosages.
Main Methods:
- A randomized study involving 150 pregnancies.
- Intravaginal misoprostol administered in 200-microg, 400-microg, and 600-microg doses at 12-hour intervals.
Main Results:
- The 48-hour successful abortion rates were 70.6%, 82%, and 96% for the respective doses.
- Mean induction-to-abortion intervals decreased with higher doses (45.0h to 22.3h).
- Higher doses correlated with increased rates of nausea, vomiting, diarrhea, and temperature elevation, though side effects were mild.
Conclusions:
- The 600-microg dose demonstrated superior efficacy for second-trimester abortion induction.
- Despite increased side effects, the 600-microg dose is recommended due to its higher success rate and acceptable side effect profile.