Outcomes of pregnancy termination by misoprostol at 14-32 weeks of gestation: A 10-year-experience

Abstract

Objective: To review outcomes of pregnancy termination between 14-32 weeks of gestation based on a10-year-experience of misoprostol use at Maharaj Nakorn Chiang Mai Hospital. Study design: A retrospective, descriptive study Material and Method: Based on the authors' prospective database, all pregnancy terminations by misoprostol between 14-32 weeks of gestation between 1998 and 2008 were reviewed. The main outcomes included success rate of termination, mean induction-to-abortion time, and complication rate. In addition, regimens and routes of drug administration as well as indications for termination of pregnancy were also analyzed. Results: Seven hundred forty one pregnancy terminations were performed using misoprostol with dosage varied from 50 mcg to 800 mcg, mostly 400 mcg intravagina every three hours. The most common indication for pregnancy termination was severe fetal thalassemia (35.8%). The majority of cases were pregnancies with live fetuses and only 18.2% were associated with a dead fetus in utero. Success rate of termination within 48 hours was 85.9%. Pregnancies with previous cesarean section accounted for 8.6% of cases. The mean gestational age was 20.94 weeks. The mean abortion time was 25.35 hours, ranging from 1.25 to 247.88 hours. The two most common adverse effects were chill and fever (43.7% and 34.3%). The rate of analgesia needed was 39.3%. No serious adverse complications such as uterine rupture were found. Conclusion: This experience suggests that misoprostol has a high efficacy for pregnancy termination with acceptable minor side effects and it is relatively safe when used with precaution.