Re: Fetal demise 31 wks aburption.
From: Efrain Ramirez (eramirezt@coqui.net)
Fri Nov 16 18:21:54 2007
Why use Cytotec if you can use PG2 in gel?
Ef
At Thu, 15 Nov 2007, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
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
>.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
>
--
"I can accept failure, but I can't accept not trying." - Michael Jordan
