Background Misoprostol, a synthetic prostaglandin analogue, has become the leading mean for terminating the pregnancy. It is not clear, however, whether misoprostol is a safe abortifacient after thirteen weeks gestation in women who have a uterine scar from a previous lower segment caesarean delivery. Objective To evaluate the efficacy and maternal side effects of misoprostol used vaginally for second trimester termination in women with a single previous lower segment caesarean delivery. Method Sixty participants with a history of previous one lower segment caesarean delivery underwent pregnancy termination for missed abortion or lethal fetal anomaly between 14-28 weeks gestation using intra vaginal misoprostol. The dose of which was 400 microgram up to 20 weeks gestation and 200 microgram thereafter, repeated every 4 hours with a 12 hours nightly rest from misoprostol application up to a maximum of 72 hours. Women having termination for similar reasons but lacking a history of cesarean section served as a control group. Results Abortion rate was 96.66% in the study group and 95% in the control group. The mean induction to abortion interval was 21.81±9.51 for the study group and 22.21±8.52 for the control group with no significant difference between the two groups. No cases of uterine rupture occurred in either groups. Conclusion Inducing abortion with lower misoprostol doses appear to be safe and effective throughout the second trimester in women with a single previous lower segment cesarean delivery.
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2014/7/1
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