SAFETY OF MISOPROSTOL IN SECOND TRIMESTER MISCARRIAGES IN PATIENTS WITH PREVIOUS UTERINE SCARS

Abstract

Objective: To assess the safety of Misoprostol in mid-trimester miscarriages in patients with previous scars. Materials and Methods: This was a cross-sectional comparative study conducted in the Department of Gynaecology and Obstetrics, Lady Reading Hospital, from January 2021 to December 2021. Two-hundred patients with second-trimester miscarriages were included in the study. They were divided into two groups, 100 patients with no previous scar as the control group and another 100 patients with a previous scar as the study group. Patients having an incomplete abortion, gestational trophoblastic disease, and more than one scar were excluded from the study. Misoprostol doses were kept vaginally in both groups. The doses were kept according to the gestational period of 13 to 24 weeks following the local protocol which was comparable with the FIGO protocol. Data analysis was done using SPSS-24. Results: The Demographic features of patients of the two groups, were comparable for maternal Age (26±5.3 Years versus 25±4.9 years), Gestational Age in weeks of (18±1.3 weeks versus117±1.6 weeks) Gravidity (4.5±1.6 versus 4.9±1.2) and of Parity (3.4 ±1.4 versus 3.6 ±1.1) which showed no significant difference with respect to age, parity and gestational age. The period needed for successful TOP was 18 hours in the control group whereas it was 36 hours in the scarred uterus with half doses. Successful termination was observed in 61% of the study group with the scared uterus and 72% in the control group. Conclusion: Our study concluded that misoprostol is safe and effective in the termination of second-trimester miscarriages with a scarred uterus. Keywords: Misoprostol, Miscarriage, Previous Uterine Scar