The efficacy of vaginal Misoprostol in second trimester medical termination of pregnancy a cohort study

Overview and Aims: To determine the efficacy of vaginal misoprostol as standard protocol in second trimester medical termination of pregnancy. Study Design: Retrospective cohort analysis. Population: Women who underwent pregnancy termination between 12 and 24 weeks for medical reasons, over a 5-year period. Methods: A standard 400mcg misoprostol dosage was given intravaginally every 6 hours until a maximum of 6 doses in a 48h period. We analyzed the failure of treatment rate, the elapsed time until resolution of pregnancy, the related complications and the influence of possible bias in the success of treatment. Results: In this study period 333 women underwent second trimester termination of pregnancy. The failure rate at 48h of the established protocol was 11.1%, with a success rate of 73% in the first 24h of treatment. Side effects and complications, such as excessive blood loss, need for transfusion, placental retention, fever or vomiting, were registered in 25.2% of the ca ses. There were no cases of uterine rupture or need for hysterectomy. Conclusions: Vaginal misoprostol is a safe, efficient and acceptable method for second trimester medical termination of pregnancy.