Compare of misoprostol and dinoprost effectivity by induced second-trimester abortion

Czech version

Authors: O. Šimetka ¹; R. Špaček ¹; P. Vašek ¹; V. Lattová ²; I. Michalec ¹; M. Procházka ²
Authors‘ workplace: Porodnicko-gynekologická klinika FN Ostrava, přednosta MUDr. O. Šimetka, Ph. D. ¹; Porodnicko-gynekologická klinika FN Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. ²
Published in: Ceska Gynekol 2011; 76(6): 472-476
Category: Original Article

Overview

Objectives:
To compare the effectivity and safety of second-trimester abortion induced by two different types of prostaglandins.

Type of study:
Retrospective study.

Setting:
Department of Obstetrics and Gynecology, University Hospital Ostrava and Department of Obstetrics and Gynecology, University Hospital Olomouc.

Methods:
Retrospective analysis of 128 second trimester abortions induced by misoprostol and 82 second trimester abortions induced by dinoprost. Total length of abortion, failure of the method, need for instrumental revision of the uterine cavity, request for epidural analgesia and length of hospital stay were compared.

Results:
In total 210 women were included. Misoprostol was used in 128 cases and dinoprost in 82 cases. The average gestational age was 18+1 in misoprostol group and 20+2 in dinoprost group. Ninety two percent of women with misoprostol aborted within 24 hours while in the dinoprost group it was 68%, withing 16 hours the number of completed abortions was 62% (misoprostol) versus 48% (dinoprost).

The method failed in 2% of cases with misoprostol and 7% of cases with dinoprost.

Conclusion:
We conclude that induction of second-trimester abortion with the use of misoprostol is safe, quick, non-invasive and comfortable method with low frequency of complications and side effects.

Key words:
misoprostol, dinoprost, abortion, induction.

Sources

1. Blanchard, K., Winikoff, B., Ellertson, C. Misoprostol use alone for termination of early pregnancy: a review of the evidence. Contraception, 1999, 59(4) p. 209–217.

2. Bugalho, A., Bique, C., Almeina, L., Faundes, A. The effectiveness of intravaginal misoprostol (Cytotec) in inducing abortion after eleven weeks of pregnancy. Studies in Family Planning, 1993, 24(5) p. 319–323.

3. Carbonell, JLL., Rodriguez, E., Delgado, E., et al. Vaginal misoprostol 800 microgram every 12 h for second-trimester abortion. Contraception, 2004, 70(1) p. 55–60.

4. Goldberg, AB., Greenberg, MB., Darney, PD. Misoprostol and pregnancy. N Engl J Med, 2001, 344(1), p. 38–47.

5. http://www.figo.org/files/figo-corp/Misoprostol_Poster_2.pdf

6. http://www.who.int/medicines/publications/essentialmedicines /en/index.html

7. http://www.misoprostol.org

8. Hynie, S. Farmakologie v kostce, Praha: Triton, 2001, 317 s.

9. Jain, JK., Kuo, J., Mishell, DR. .Jr. A comparison of two dosing regimens of intravaginal misoprostol for second-trimester pregnancy termination. Obstet Gynec, 1999, 93(4) p. 571–575.

10. Jain, JK., Mishell, DR. A comparison of misoprostol with and without laminaria tents for induction of second-trimester abortion, Am J Obstet Gynecol, 1996,175, p. 173-177.

11. Roztočil, A., Jelínek, J. Prostaglandiny v porodnictví. 1.vyd. Z.Frömmel. 1997, s. 29-38.

12. Sobieszczyk, S., Bręborowicz, G. Management recommendations for postpartum hemorrhagie. Arch Perinat Med, 10 (4), 2004, p. 2.

13. Tang, OS., Gemzell-Danielsson, K., Ho, PC., Misoprostol: pharmacokinetic profiles, effects on the uterus and side-effects. Inter J Gynecol Obstet, 2007, 99, p. 160-167.

14. USFDA. “Off-Label” and Investigational Use of Marketed Drugs, Biologics and Medical Devices. Guidance for Institutional Review Boards and Clinical Investigators: 1998 Update. Available at: www.fda.gov/oc/ohrt/irbs/offlabel.html. Accessed January 31, 2005.

15. Wing, DA., Lovett, K., Paul, RH. Disruption of prior uterine incision following misoprostol for labor induction in women with previous cesarean delivery. Obstet Gynec, 1998, 91(5 Pt 2) p. 828–830.

16. Wong, KS., Ngai, CS., Yeo, EL., et al. A comparison of two regimens of intravaginal misoprostol for termination of second trimester pregnancy: a randomized comparative trial. Contraception, 1996, 54, p. 23–25.