An experience with the use of Misoprostol in second trimester miscarriages, in women with prior cesarean births.

OBJECTIVE

To determine the success rate, frequency of complications and, side effects of misoprostol used, for second-trimester miscarriages, in women with history of previous cesarean section.

METHODOLOGY: This cross sectional study was done at Lady Reading Hospital, Peshawar, from January 2021 to December 2022.The sample included 90 women, with a history of previous one cesarean section, undergoing medical management of second-trimester miscarriage. Outcomes noted were, success rate, frequency of scar complications and side effects.

RESULTS

The mean age of sample of 90 patients, was 28.87±4.6. The mean induction to expulsion time was 11 hours ± 3.9. Complete expulsion was achieved in 67.7% (61/90) cases. The need for surgical evacuation of retained products of conception, was observed in 32.5% (29/90) of cases. Scar complications were noted in 2.2% (2/90) cases. The need for surgical evacuation was more common with the vaginal route of administration as compared to the sublingual route i.e. 50% (20/40) vs 18% (09/50), p-0.001. Diarrhea was significantly associated with sublingual route of administration, p-0.001. Fever was common with the vaginal route, 47.5% (19/40) vs 26% (13/50), p-0.03. The mean induction to termination time was significantly shorter in the sublingual route group. (p-0.001).

CONCLUSION

Misoprostol successfully and safely concludes the process of second trimester miscarriage in carefully selected women with a history of previous one cesarean birth.