OB-GYN-L Messages for November, 2007: Re: Fetal demise 31 wks aburption.

Re: Fetal demise 31 wks aburption.

From: FRANCES WREN

fwren@shaw.ca

Sat Nov 17 10:33:09 2007

I don't think the gel works as well as cytotec...however i admit it is usually the gel that i use. frances wren

>----- Original Message -----
From: eramirezt@coqui.net (Efrain Ramirez) Date: Friday, November 16, 2007 6:24 pm Subject: Re: Fetal demise 31 wks aburption. To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>

> 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

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<DIV>I don't think the gel works as well as cytotec...however i admit it is usually the gel that i use.</DIV>

><DIV>frances wren ----- Original Message ----- From: eramirezt@coqui.net (Efrain Ramirez) Date: Friday, November 16, 2007 6:24 pm Subject: Re: Fetal demise 31 wks aburption. To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> > 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.
0;BR>> >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. > > > >>-- > >>         &nbsp ;                       Take care, John > >> > >-- > >                                 Take care, John > > > > -- > "I can accept failure, but I can't accept not trying." - Michael > Jordan</DIV>

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