Termination of pregnancy in the second trimester – the course of different therapy regimens
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Jana Franzis Franke
,
Kathrin Oelmeier
Abstract
Objectives
To compare two prostaglandin analogs and two application intervals between mifepristone and the prostaglandin analog administration on the time to abortion in second trimester termination of pregnancy. Other endpoints were live birth rate and fetal lifetime after expulsion.
Methods
Retrospective data of 373 abortions performed were evaluated. Four medical induction subgroups and two feticide subgroups were considered. The definition criteria of the subgroups were the choice of administered prostaglandin analog (misoprostol vs. sulprostone) and the time interval between mifepristone and prostaglandin analog administration (48 vs. 24 h). The outcome parameters were the time to complete uterine evacuation (TCUE), the live birth rate and duration of fetal life.
Results
In the misoprostol subgroups, the median TCUE was 1.6 h longer in the 24-h group than in the 48-h group (p=0.950). In the sulprostone subgroups, the median TCUE was 1.9 h shorter in the 24-h group than in the 48-h group (p=0.950). The median TCUE was shorter for sulprostone than for misoprostol in all six subgroups (p<0.001). The rate of fetal live births ranged between 13.6 and 15.9% within the medical induction subgroups (p=0.969). The median fetal lifetime was slightly shorter in the sulprostone groups than in the misoprostol groups (p=0.563).
Conclusions
Both application intervals and prostaglandin analogs are similarly effective. The therapy regime should be adapted to the personal preferences of the woman, the situational and clinical conditions.
Acknowledgments
We thank everyone who voluntarily dedicated his or her time and effort.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. J.F. Franke: project development, data collection, and manuscript writing; K. Oelmeier, M. Möllers, U. Möllmann, J. Braun, H. Köster, and W. Klockenbusch: manuscript writing/editing; L. Kerschke: project development, data management, and data analysis; R. Schmitz and K. Hammer: project development, data management, and manuscript writing/editing.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board.
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Data availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- WAPM Guideline
- Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation
- Original Articles – Obstetrics
- Racial and ethnic distribution of US randomized controlled trials in obstetrics: a retrospective review
- Impact of earlier gestational diabetes screening for pregnant people with obesity on maternal and perinatal outcomes
- Variations in uterine closure technique: an institutional survey of obstetricians and implications for patient counseling and prevention of adverse sequelae
- Termination of pregnancy in the second trimester – the course of different therapy regimens
- Hyponatremia among preeclampsia patients – a potential sign of severity
- Effect of combined paracetamol and dexamethasone vs. paracetamol on postoperative nausea vomiting after cesarean section
- Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
- Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study
- The effect of advanced maternal age on perinatal outcomes in nulliparous pregnancies
- Evaluating the correlation between amniotic fluid volume and estimated fetal weight in healthy pregnant women
- Metabolic characterization of amniotic fluid of fetuses with isolated choroid plexus cyst
- Does a cervical pessary reduce the rate of preterm birth in women with a short cervix?
- Research progress on N6-methyladenosine in the human placenta
- Why are women deciding against birth in alongside midwifery units? A prospective single-center study from Germany
- Pregnancy hypothyroidism incidence and complications using the 2011 and 2017 ATA cutoff values. Experience at a maternity hospital in a densely populated area in Mexico City
- Expression pattern and clinical significance of microRNA-let-7a and IFN-gamma in placental tissue of patients with preeclampsia with severe features
- Original Articles – Fetus
- Management of neonates with 35 weeks of gestational age or more with infectious risk factors at birth: opportunities for improvement
Articles in the same Issue
- Frontmatter
- WAPM Guideline
- Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation
- Original Articles – Obstetrics
- Racial and ethnic distribution of US randomized controlled trials in obstetrics: a retrospective review
- Impact of earlier gestational diabetes screening for pregnant people with obesity on maternal and perinatal outcomes
- Variations in uterine closure technique: an institutional survey of obstetricians and implications for patient counseling and prevention of adverse sequelae
- Termination of pregnancy in the second trimester – the course of different therapy regimens
- Hyponatremia among preeclampsia patients – a potential sign of severity
- Effect of combined paracetamol and dexamethasone vs. paracetamol on postoperative nausea vomiting after cesarean section
- Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
- Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study
- The effect of advanced maternal age on perinatal outcomes in nulliparous pregnancies
- Evaluating the correlation between amniotic fluid volume and estimated fetal weight in healthy pregnant women
- Metabolic characterization of amniotic fluid of fetuses with isolated choroid plexus cyst
- Does a cervical pessary reduce the rate of preterm birth in women with a short cervix?
- Research progress on N6-methyladenosine in the human placenta
- Why are women deciding against birth in alongside midwifery units? A prospective single-center study from Germany
- Pregnancy hypothyroidism incidence and complications using the 2011 and 2017 ATA cutoff values. Experience at a maternity hospital in a densely populated area in Mexico City
- Expression pattern and clinical significance of microRNA-let-7a and IFN-gamma in placental tissue of patients with preeclampsia with severe features
- Original Articles – Fetus
- Management of neonates with 35 weeks of gestational age or more with infectious risk factors at birth: opportunities for improvement
