M. Rajic

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    Termination of second trimester pregnancies with
    mifepristone and misoprostol
    Rajic, M; Vrhkar, N; Stritar, BS; Tul Mandic, N
    Division of Gynaecology and Obstetrics, Department of Perinatology,
    University Medical Centre Ljubljana, Ljubljana, Slovenia
    Objective: To evaluate the safety and efficacy of termination of
    pregnancy (TOP) for medical reasons (structural fetal congenital
    anomalies, fetal chromosomal abnormalities, intrauterine fetal
    death, early preterm prelabour rupture of membranes) using
    mifepristone and misoprostol (MI-MI) between 11 and 22 weeks
    of gestation.
    Methods: We collected data from all women requiring TOP with
    MI-MI for medical reasons. The protocol consisted of 200 mg of
    mifepristone orally, 36–48 hours later 800 lg of misoprostol
    vaginally, followed by 400 lg buccally every 3 hours until TOP
    (maximum of four doses in 24 hours). If the placenta was
    retained, uterotonics were adminsitered, and a decision was made
    whether to evacuate the uterus surgically. The data were analysed
    using the statistical software program SPSS, version 18.
    Results: A total of 435 women were enrolled in the study (we
    analysed 157 cases, the remainder will be analysed by the
    beginning of FIAPAC Conference 2012). The mean gestational age
    was 16.5 weeks. For 58 (36.9%) women this was their first
    pregnancy. The method was successful in 156 (99.4%) cases. The
    average time interval from the beginning of the procedure till
    TOP was 47.3 hours (13.8–168 hours). The average duration of
    hospital stay was 39.3 hours (25.0–167 hours). In 40 (25.5%)
    cases surgical evacuation of the uterus after TOP was performed.
    Conclusions: The use of MI-MI is safe, effective and non-invasive
    regimen for TOP for medical reasons between 11 and 22 weeks of
    gestation.