Re: Fetal demise 31 wks aburption.
From: R. Daniel Braun (rd.braun@gmail.com)
Thu Nov 15 19:06:58 2007
POWER POWER is totally lacking in this study.
Dan
On Nov 15, 2007 5:04 PM, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. <
johnprov@sympatico.ca> wrote:
> At Thu, 15 Nov 2007, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
> wrote:
> >
> 1: Obstet Gynecol. 2005 Feb;105(2):352-6. Links
> Misoprostol for second-trimester pregnancy termination in women with a
> prior cesarean delivery.Dickinson JE.
> School of Women's and Infants' Health, The University of Western
> Australia, King Edward Memorial Hospital for Women, 374 Bagot Road,
> Subiaco, Perth, Western Australia 6008, Australia.
> jand@cyllene.uwa.edu.au
>
> OBJECTIVE: To evaluate the use of misoprostol in second-trimester
> abortion in women with prior cesarean deliveries. METHODS: A review of
> women with prior cesarean deliveries undergoing abortion at 14-28 weeks
> of gestation for a fetal anomaly over a 7.5-year period. Outcome data
> were compared with a contemporaneous cohort of women with unscarred
> uteri undergoing the same procedure. Misoprostol was used to induce
> abortion in all cases, and a variety of dosage regimens were used, the
> most frequent being 400 mug vaginally every 6 hours (71.3%). RESULTS:
> During the study period, 720 consecutive women underwent a
> second-trimester abortion for a fetal anomaly using misoprostol. One
> hundred one women (14%) had at least 1 prior cesarean delivery: 78 women
> had 1, 19 women had 2, and 4 women had 3 prior cesarean deliveries.
> Women with a prior cesarean birth were significantly older (30 years
> [interquartile range 26-35] versus 33 years [29-37], no cesarean
> delivery versus cesarean delivery, P = < .001) and of increased parity.
> The median gestational age at delivery was 19.4 weeks (interquartile
> range 18-20.7) versus 19.3 weeks (17.7-21), no cesarean delivery versus
> cesarean delivery, P = .48. The presence of a prior uterine scar did
> not impact upon abortion duration (16.6 hours [12.1-23.8] versus 14.5
> hours [11.4-21.4], no cesarean delivery versus cesarean delivery, P > .07). No differences in blood loss, major hemorrhage, or blood
> transfusion occurred. There was no case of uterine rupture or
> hysterectomy. CONCLUSION: In second-trimester abortion, the use of
> misoprostol in women with prior cesarean delivery was not associated
> with an excess of complications compared with women with unscarred
> uteri. LEVEL OF EVIDENCE: II-2.
>
> >
> >--
> > Take care, John
> >
>
> --
> Take care, John
>
--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
