Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , January and February 2023, , Pages 113-119
Abstract
Background: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter ...
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Background: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol(The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to birth time were the main outcomes.Results: The mean of time between ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hour respectively, P-value = 0.0001). After intervention Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Time from insertion to birth in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter as a cervical ripening method in our study.
Obstetrics and Gynecology
Mohammad Reza Zeraati; Hojjat Torkmandi; Mohammad Abdi; Mohammad Reza Jamshidi; Alireza Safaie
Volume 8, Issue 1 , November and December 2022, , Pages 86-94
Abstract
Pyrexia and shivering are the most popular side effects of postpartum administration of misoprostol, but other side effects of this drug are very rare. A 27-year-old pregnant female patient was admitted to Ayatollah Mousavi hospital (Zanjan, Iran), complaining about severe headache and the primary diagnosis ...
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Pyrexia and shivering are the most popular side effects of postpartum administration of misoprostol, but other side effects of this drug are very rare. A 27-year-old pregnant female patient was admitted to Ayatollah Mousavi hospital (Zanjan, Iran), complaining about severe headache and the primary diagnosis of cerebral venous thrombosis. Treatment was successful after primary investigations and planed therapy for Cerebral Venous Thrombosis (CVT). Following the decision on terminating the pregnancy, five tablets of Sublingual misoprostol (200 mg) was used once evacuation of pregnancy remnants was done. About thirty minutes after the administration of misoprostol, onset of severe shivering and tachycardia (201/min) with high fever (about 41°C) and hypertension (182/123 mmHg) was observed. National Adverse Drug Reaction (ADR) form was completed. All of symptoms were alleviated 30 minutes after administration of Paracetamol 1gram (Intravenous infusion) followed by Metoprolol 50 mg (orally). According to the literature, we listed the various side effects of misoprostol. Even though the side effects of misoprostol are diverse and rare, the simultaneous occurrence of these side effects is not cited till date. These incidents are reported to the authorities as per ADR policy; nonetheless, no preventive measures are implemented. This necessitates medical educational policies to be taken into consideration to educate healthcare providers throughout their professional career as well as research.
Obstetrics and Gynecology
Reda Hemida
Volume 7, Issue 4 , March and April 2022, , Pages 356-357
Abstract
Dear Editor- in –Chief of Journal of Obstetrics, Gynecology and Cancer Research (JOGCR),I write to you regarding the published article in The Journal of Obstetrics, Gynecology, and Oncology research titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Dear Editor- in –Chief of Journal of Obstetrics, Gynecology and Cancer Research (JOGCR),I write to you regarding the published article in The Journal of Obstetrics, Gynecology, and Oncology research titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy” by Aminimoghaddam et al that was published on 27th of September, 2019 [1]. The article was revised with interest and raised for me some serious concerns.
Obstetrics and Gynecology
Soheila Aminimoghaddam
Volume 7, Issue 4 , March and April 2022, , Pages 358-360
Abstract
Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy,” published in 2019 in your journal.I want to first thank Professor Hemida for reading my paper carefully and sharing his comments. I highly believe that sharing comments and raising scientific questions could benefit our society. I hope that the responses that the co-authors have provided be helpful and to the point. As he suggested, I am willing to let the journal publish the responses in the next issue.
Obstetrics and Gynecology
Fatemeh Keikha; Mahshid Shooshtari; Narges Zamani
Volume 7, Issue 3 , January and February 2022, , Pages 243-246
Abstract
Intravaginal misoprostol is used worldwide with excellent results for second-trimester pregnancy termination. However, it has a rare but serious complication of uterine rupture, both in previously scarred and unscarred uteri. In this report, we present a case of this rare complication in an unscarred ...
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Intravaginal misoprostol is used worldwide with excellent results for second-trimester pregnancy termination. However, it has a rare but serious complication of uterine rupture, both in previously scarred and unscarred uteri. In this report, we present a case of this rare complication in an unscarred uterus during termination with misoprostol. Uterine rupture was found on laparotomy after the patient showed signs of shock during termination. A 2- to 3-cm laceration was detected in the uterine wall along with the left cornea. The placenta was attached to the uterus on the other side. We found an unusual pregnancy in the cornea and successfully repaired it. Although using misoprostol for termination is safe, a regimen protocol should be established. However, uterine structure and implantation safety should be confirmed before administrating misoprostol. This case highlights a difficult diagnosis of abnormal placentation, especially cornual ectopic pregnancy.
Obstetrics and Gynecology
Mitra Modares Gilani; Fariba Yarandi; Narges Zamani; Shaghayegh Nowroozi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 77-82
Abstract
Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and ...
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Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and misoprostol for the enhancement of TZ visibility in vaginal colposcopy of premenopausal and postmenopausal women.Materials & Methods: In this clinical trial, 78 patients with unsatisfactory colposcopy were randomly divided into three groups. Group 1 (n=25) received 25 µg of vaginal estradiol for 14 days prior to colposcopy. Group 2 (n=27) received 400 µg of misoprostol 12 h prior to colposcopy. Group 3 (n=26) served as the control group and did not receive any medication. Visibility of the TZ, age, body mass index (BMI), history of vaginal delivery, history of sexually transmitted diseases, history of human papillomavirus (HPV), the reason for colposcopy, and drug-related side effects were compared among the three groups and also between premenopausal and postmenopausal women. Data were analyzed using analysis of variance (ANOVA), Kruskal-Wallis, Chi-square, and Fisher’s exact tests.Results: The percentage of TZ visibility was 72%, 55.6%, and 26.9% in the estradiol, misoprostol, and control groups, respectively (P < /em>=0.005). These values were 70%, 33.3%, and 0%, respectively, in postmenopausal women (P < /em>=0.043) and 60%, 72.7%, and 33.3%, respectively, in premenopausal women (P < /em>=0.152). Regarding drug-related side effects, there was no statistically significant difference between the three groups (P < /em>=0.374).Conclusion: Estradiol was significantly superior to misoprostol for the enhancement of TZ visibility, particularly in postmenopausal women, with no difference regarding side effects.
Obstetrics and Gynecology
Fatemeh Golshahi; Fariba Yarandi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 121-125
Abstract
With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive ...
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With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive cesarean section history while some others have no report of such effect. This complication cannot be predicted and can occur under various circumstances with different misoprostol regimens. Hereby, we reported three cases with positive cesarean section history undergoing second-trimester pregnancy termination due to preterm premature rupture of the membranes (PPROM) who developed uterine rupture with similar misoprostol dosages. Finally, we conclude that more cautions should be undertaken in the setting of PPROM with previous history of cesarean section or gestational age >20 weeks about uterine rupture risk and full recommended misoprostol dose must not be administered to prevent life-threatening events.
Obstetrics and Gynecology
Mahboobeh Shirazi; Mehnoosh Torkzaban; Samira Fallah; Marjan Ghaemi
Volume 7, Issue 1 , September and October 2021, , Pages 20-24
Abstract
Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management ...
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Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials and Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups.Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P < /em><0.05) in the prophylaxis compared to the treatment group.Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester.
General Gynecology and Pelvic Floor
Behnaz Nouri; Ahmad Reza Baghestani; Paricheher Pooransari
Volume 6, Issue 2 , March 2021, , Pages 87-94
Abstract
Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial ...
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Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.Methods: In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).Results: The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P < /em>>.05), but had different frequency of surgical types (P < /em>=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P < /em>=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P < /em>=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P < /em>>.05).Conclusion: The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.
Obstetrics and Gynecology
Mehrnaz Valadan; Mohadeseh Mojarad; Elham Feizabad
Volume 5, Issue 3 , November 2020, , Pages 88-92
Abstract
Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol ...
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Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol has some side effects, including uterine cramps, vaginal hemorrhage, nausea, vomiting, and fever-like feelings, the severity of which escalates by increasing the dosage. Therefore, in this study, we aimed to compare vaginal misoprostol in two different dosages of 200 and 400 μg with a control group to prescribe the lower dosage of misoprostol in case they were equally effective.Materials & Methods: In this randomized clinical trial study, 87 patients, who had hysteroscopy indications at Yas Hospital, were randomly assigned into three groups (i.e., 200 μg vaginal misoprostol, 400 μg vaginal misoprostol, and placebo). Afterward, the dilatation time of the cervical response and side effects associated with medication and surgery were assessed.Results: The mean dilatation time in the 200 μg misoprostol, 400 μg misoprostol, and placebo groups were 46.7±35.8, 36.8±31.1, and 67.6±49.5 seconds, respectively. These differences were significant (P=0.038). Conclusion: It seems that administering vaginal misoprostol is an easy, effective, and safe procedure for cervical preparation before the hysteroscopy. Considering that increasing the dosage of misoprostol did not significantly change the dilatation time, it is recommended that 200 μg misoprostol be used to reduce the side effects.
Shapoor Shoja; Seyedeh Reyhaneh Yousefi Sharami; Shole Shahgheibi; Farnaz Zand-Vakili; Shamsi Zare; Daem Roshani; Nasrin Sofizadeh
Volume 4, Issue 3 , September and October 2019, , Pages 105-110
Abstract
Background & Objective: The induction of labor is needed to terminate pregnancy in pregnant women lacking labor pain. Common indications of labor induction include rapture of membranes without labor pain, hypertension, fetus’ unreassuring conditions and post-term pregnancies. The purpose of ...
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Background & Objective: The induction of labor is needed to terminate pregnancy in pregnant women lacking labor pain. Common indications of labor induction include rapture of membranes without labor pain, hypertension, fetus’ unreassuring conditions and post-term pregnancies. The purpose of this study is to compare and contrast vaginal misoprostol with Foley catheter in cervical ripening and the induction of labor.
Materials & Methods: This study was done on pregnant women who showed pregnancy termination indication for any cause, using randomized clinical trial method. Inclusion criteria in this study included gestational age equal to or greater than 37 weeks and ultrasonography of the first trimester, unfit cervix Bishop Score 1 equal to or less than 4, single-shot pregnancies, vertex display, intact membrane and the subject’s consent to participate in the research. Patients were divided into two equal groups of 60. Oxytocin was used for the induction of labor if the patient did not enter the active phase.
Results: In this study, the average age of women in Foley catheter group and misoprostol group were 27.03±4.04 and 26.85±3.49 respectively in which there was no meaningful difference statistically. However, the average age of women with cesarean delivery was statistically more than the average age of women with NVD. Bishop score 2 has demonstrated more increase in comparison to Bishop score 1 among Foley catheter group rather than misoprostol group. The average of labor speed, the number of women with NVD and the failure of induction in Foley catheter group exceeded those in misoprostol group.
Conclusion: According to the results gained in this study, Foley catheter application for induction of labor had better outcomes in comparison to vaginal misoprostol. It can even be a better alternative for vaginal misoprostol; hereby the side effects of misoprostol such as possible tachysystol and fetus distress can be prevented.
Soheila Aminimoghaddam; Afsar Ahmad; Setare Nassiri
Volume 4, Issue 3 , September and October 2019, , Pages 111-116
Abstract
Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 ...
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Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 deliveries both in the United States and Europe. The aim of this study was to prove the noninferiuority and safety of misoprostol use in cervical ripening in patient with molar pregnancy.
Materials & Methods: This retrospective cohort study was performed on 150 women with molar pregnancy referred to Firuzgar and Mirza-koochack-khan hospitals in Tehran, between 2006 and 2013. We defined group 1 as 100 patients without Misoprostol pretreatment and group 2 as 50 patients with Misoprostol pretreatment. There was no significant difference in the number of complete or partial mole between the two groups. They were followed by serum ß-hCG level and if it became plateaued in 4 measurements or rose more than 10% in 3 measurements in a period of three weeks, would be defined as persistent.
Results: We found no significant difference of maternal age, fundal height, gestational age, gravity, parity, number of previous abortions and prevalence of complete and partial moles between the two groups. A total of 27 (27%) patients in non-Misoprostol group and 5 (10%) patients in Misoprostol group developed Persistent GTN (P < /em><0.05). We observed no case of trophoblastic embolism in the misoprostol group.
Conclusion: Misoprostol cervical ripening resulted in lower Persistent GTN incidence. Also, trophoblastic embolism following misoprostol administration is so rare that we observed no case.
Shayesteh Parashi; Vahideh Astaraei; Mansoureh Vahdat; Parisa Dini; Mahdis Mohammadianamiri
Volume 3, Issue 4 , November and December 2018, , Pages 143-147
Abstract
Background & Objective: Postoperative hemorrhage is one of the most frequently cited complications of total abdominal hysterectomy (TAH). This study aimed to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies.
Materials ...
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Background & Objective: Postoperative hemorrhage is one of the most frequently cited complications of total abdominal hysterectomy (TAH). This study aimed to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies.
Materials & Methods: This study was a single-blind randomized controlled trial (RCT). The statistical population included all women who were candidates of hysterectomy in 2017 and 2018. A total of 132 patients were randomly selected and classified into two groups of misoprostol (N=66) and placebo (N=66). Examining intraoperative blood loss was considered a primary outcome. Moreover, levels of hemoglobin before and 24 hours after the surgery, the need for a blood transfusion, febrile morbidity, and the duration of hospitalization were regarded as secondary outcomes. The means of bleeding in the two groups were compared using a t-test.
Results: There were no significant differences between the two groups in the baseline characteristics (P < /em><0.05). After the surgery, the mean of hemoglobin values was lower in the placebo group compared to the misoprostol one, and this difference was statistically significant (P < /em><0.001). There was a significant difference in intraoperative blood loss between the two groups, and it was significantly higher in the placebo group (P < /em><0.001).
Conclusion: Taking a single preoperative dose of sublingual misoprostol is effective in reducing intraoperative blood loss after total abdominal hysterectomies. Additionally, this intervention led to a decline in hemoglobin.
Forough Javanmanesh; Maryam Kashanian; Sara Mirpang
Volume 3, Issue 2 , May and June 2018, , Pages 49-52
Abstract
Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, ...
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Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, were selected by simple randomization sampling method and randomly assigned into two groups. Drug group received 10mg daily Letrozole (4 tablets of 2.5mg) for 3 days prior to taking Misoprostol and the placebo group received daily placebo (4 tablets with the exact appearance of Letrozole) with the same instructions. After 3 days, Misoprostol was given to all the participants based on their gestational ages. The data were analyzed by SPSS 16 software, using independent sample t-test and Chi-square test.
Findings: 21 women (45.7%) had a successful complete abortion, and curettage was needed for 25 women (54.3%). Successful abortion rate was significantly higher in the group receiving Letrozole (78.3%) than the group receiving placebo (13.0%; p=0.0001). Mean induction-abortion interval was 22.61±7.721 hours in the drug group and 24.09±8.251 hours in the placebo group, which was not significantly different (p>0.05). There was no significant difference between the two groups in terms of vaginal bleeding and adverse effects.
Conclusion: Using 10mg daily Letrozole for 3 days followed by oral Misoprostol results in a significantly higher rate of complete abortion compared with placebo in women with a gestational age of less than 20 weeks.
Mansooreh Zanjani; Jalil Kohpayeh; Zhila Karimi
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Vaginal misoprostol is said to dissolve better in an acidic environment, thus, in this study we aimed to evaluate the influence of increasing vaginal acidity on the effectiveness of vaginal misoprostol for the induction of midtrimester pregnancy using acidic environment.
Methods: A total ...
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Background: Vaginal misoprostol is said to dissolve better in an acidic environment, thus, in this study we aimed to evaluate the influence of increasing vaginal acidity on the effectiveness of vaginal misoprostol for the induction of midtrimester pregnancy using acidic environment.
Methods: A total of 40 women requiring second trimester pregnancy termination were randomly assigned to one of two treatment groups: (A) in the saline group, 400 µg of intra-vaginal misoprostol was moistened in normal saline before the vaginal insertion as controls (n = 20); and (B) in the acetic acid group, the acidity of the vagina was increased with 3% of acetic acid, (4 mL of 3% acetic acid was delivered into the vagina every 6 hours) before the insertion of an initial dose of 400 µg misoprostol (n = 20). Then 200 µg dosage was repeated every 4 hours for a maximum of 5 doses within 24 hours. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 hours and if no response was achieved, this was considered a failure of therapy.
Results: There was no significant difference in the vaginal pH between the control and intervention groups before the vaginal application of acetic acid (5.80 ± 0.62 versus 5.89 ± 0.49, P = 0.622,). The vaginal pH was significantly lower in the acetic acid group after the vaginal application of acetic acid compared to the control group (5.11 ± 0.56 versus 5.80 ± 0.62, P = 0.001). Overall, 95% of pregnancies were successfully terminated in the acetic acid group compared to 85% in the control group. These differences were not statistically significant (P =0.241). The success rate within 24 hours and 48 hours, the adverse effects, mean termination time, total misoprostol administered, and the number of curettage were, also, comparable between the two groups.
Conclusions: Findings from this study shows that increasing Vaginal acidity does not improve the efficacy of misoprostol administered intra-vaginally for the second trimester pregnancy termination.
Masoumeh Fallahian; Shahrzad Tavana
Volume 1, Issue 1 , May and June 2016
Abstract
Abortion is desperately selected by some females who cannot continue their unintended pregnancies in all societies, some will suffer complications and some will die. Annual number of induced abortion has increased in the developing countries but the maternal death related to unsafe abortion has declined ...
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Abortion is desperately selected by some females who cannot continue their unintended pregnancies in all societies, some will suffer complications and some will die. Annual number of induced abortion has increased in the developing countries but the maternal death related to unsafe abortion has declined in the world since 2003. Medical abortion has contributes to this decline. In Iran, abortion rate of one per four female is estimated. The current study evaluated the technique of induced abortion among mothers with parity score of 0 - 1 (0.49), who attempted abortion; approximately 65 females performed induced abortion medically by misoprostol in 50.7%, surgically by curettage in 28% and manual vacuum aspiration (MVA) or vacuum curettage in 18% of the cases at the gestational age of six weeks. Since previously mentioned technique of abortion was surgical; the unsafe and clandestine abortions with 1.35% maternal death in the 1990s later changed to medical abortion by dinoprostone (prostaglandin E2) in the 2000s and now medical abortion is replaced by misoprostol (prostaglandin E1) in the 2010s. Complete abortion occurred in approximately 60% of the misoprostol cases. The parity score and gestational age in abortion cases have declined. Failure of withdrawal method of contraception (57%) and unmet need to modern effective contraception are contributing factors in these abortions. The trends in abortion are replaced by medical abortion with less morbidity at earlier stages of pregnancy. Traditional contraception and lack of effective contraceptive facilities and accessibilities are likely to increase unintended pregnancies and consequently abortions as well.
