SAFE MEDICAL ABORTION IN THE SECOND TRIMESTER OF PREGNANCY
ESC Congress Library. Posokhova S. May 10, 2018; 208079; ESC49
Svitlana Posokhova
Svitlana Posokhova
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Abstract
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 Second trimester abortions constitute 10-15% of all induced abortions worldwide but are responsible for two-thirds of major abortion-related complications. Second-trimester abortion is associated with more morbidity and mortality and, for some women, more social or emotional challenges than first-trimester abortion . During the last decade, medical methods for second trimester induced abortion have been considerably improved and become safe and more accessible. Methods: A prospective study was conducted in the Department of Obstetrics and Gynecology.  Interruption of pregnancy was conducted on 94 women in the second trimester in the period 13-21 week due to diagnosed with multiple malformations of the fetus.  We used the following scheme for medical abortion. All women were prescribed  200 mg mifepristone and after 24 hours they received unlimited doses of misoprostol 400 micrograms sublingually for complete expulsion of the fetus and placenta without operative intervention and use of oxytocin. Results: Maximum number  of  patients 45% were in the age of 26-30 years. About 80% of women belonged to urban community. Exactly 25% patients had 3 or more children, 15% were primigravidae, and 60% had 1 or 2 children. The highest percentage of abortions occurred in the period 18-21 week - 72.2 %. According to our data, the number of doses of misoprostol (2-11 doses) to the expulsion of the fetus and placenta depended of the termination of pregnancy. For nulliparous women was the most favorable period of interruption of pregnancy was 13-15 weeks (3 doses of misoprostol and abortion up to 6 hours). For nulliparous women in all period of pregnancy average number of doses of misoprostol ranged from 3,2 -3,75 and abortion averaged from 6.0 to 8.25 hours. Surgical intervention (curettage) was required in 3 cases, 3.2% for reason of incomplete abortion and bleeding. Conclusions:  Thus, the scheme we used to terminate the pregnancy in the second  trimester was effective at 96.8% of cases. Key words: pregnancy, second trimester, mifepristone, misoprostol, safe abortion.
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