How to manage unresponsiveness to misoprostol in failed second trimester pregnancy termination

• Main Authors: Pongsatha S., Tongsong T.
• Format: Article
• Language: English
• Published: 2014
• Online Access: http://www.scopus.com/inward/record.url?eid=2-s2.0-84875723465&partnerID=40&md5=ba50af38982ebf18eba28baa68fdafb8; http://cmuir.cmu.ac.th/handle/6653943832/4222
• Institution: Chiang Mai University

Aim: To present the experience of management of second trimester pregnancy termination by misoprostol after failure to abort within 48 h of its use. Material and Methods: A retrospective, cohort descriptive study was carried out in the Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University Thailand between 1998 and 2010. All women at 14-28 weeks of gestation who failed to abort using misoprostol within 48 h were included. Management of failed pregnancy termination among these women is described here. Results: Of a total of 680 women undergoing termination of pregnancy, 68 (10%) failed to abort. Mean maternal age was 28.71 years and mean gestational age was 19.91 weeks. Further management after failure included additional administration of misoprostol only (19.1%), modified condom balloon technique only (17.7%), modified condom balloon technique plus other methods (16.1%), while 47.1% needed only oxytocin as necessary. The mean interval between initiation of termination and delivery was 96.97 h. Conclusion: Failure of pregnancy termination using misoprostol can be successfully managed by introducing additional misoprostol, modified condom balloon technique and oxytocin infusion. These methods should be considered before proceeding to hysterotomy. © 2012 The Authors.