Comparison between Rectal Misoprostol and Vaginal Misoprostol for First Trimester Termination of Pregnancy in Patients with Previous Uterus Surgery

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor, Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 B.Sc. of Midwifery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Induced abortion is a medical or surgical termination of pregnancy before fetal viability for maternal or fetal indication. Recently, medical treatment has been more commonly used due to surgical complications. In this context, misoprostol has been widely prescribed. The aim of this study is to compare rectal misoprostol and vaginal misoprostol for first trimester termination of pregnancy in patients with previous uterus surgery.
Methods: This clinical trial study was conducted on 80 pregnant women at first trimester of pregnancy with history of previous cesarean section who referred for pregnancy termination to Ghaem hospital of Mashhad, Iran in 2010. They were randomly divided into two groups of misoprostol 800 microgram vaginal and 800 microgram rectal. The complication and outcomes of abortion were evaluated in two groups. Data were analyzed by SPSS software version 11.5, chi-square, t-student, Mann-Whitney and Kruskal-Wallis tests. P value less than 0.05 was considered significant.
Results: Mean age of patient in rectal group was 29.41±5.9 years and 30.46±5.8 years in vaginal group. Mean gestational age was 9.6±1.9 weeks in rectal group and 9.7±2.3 weeks in vaginal group. Complete evacuation occurred in 84.6% of cases in rectal group and 75.6% of patients in vaginal group. 6 patients (15.4%) in rectal group and 10 cases (24.4%) in vaginal group needed to undergo curettage. No significant differences were observed between two groups in terms of fever (p=0.361), nausea (p=0.814), diarrhea (p=0.676), chills (p=0.890), sedation (p=0.258) and need to transfusion (p=0.971) and no cases of uterus rupture was found.
Conclusion: Both rectal and vaginal misoprostol is effective for medical termination of pregnancy in first trimester of pregnancy in patients with previous cesarean section.
 

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