Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol

Objectives: To determine the factors influencing the abortion interval (Al) for medical termination of second-trimester pregnancy using misoprostol. Materials and Methods: All patients who were admitted for second-trimester pregnancy termination between January 2008 and August 2013 were reviewed. Those who received either 200 mu g or 400 mu g of priming vaginal misoprostol, followed by 200 mu g of misoprostol orally at 6-hour intervals were enrolled. Results: In a total of 101 patients, delivery occurred within 24 hours of commencement in 62 patients (61%) and within 48 hours in 84 patients (83%), and the median Al was 16.5 hours. One patient (1%) failed to deliver. The remaining 100 fetuses were delivered successfully, and the median Al was 16.3 hours. Higher parity [hazard ratio (HR) = 1.28, p = 0.041, the presence of intrauterine fetal demise (HR = 2.66, p = 0.003), and the presence of premature preterm rupture of membranes (HR = 4.51, p = 0.003) were associated with shorter Al. Additionally, all women with premature preterm rupture of membranes delivered successfully within 12 hours; higher parity (odds ratio = 2.12, p = 0.01) and lower fetal birth body weight (odds ratio = 0.992, p = 0.01) were associated with successful delivery within 12 hours. There was no significant difference in Al in the groups that received different doses of priming vaginal misoprostol (200 mu g vs. 400 mu g). Conclusion: Higher parity, intrauterine fetal demise, and preterm premature rupture of membranes were associated with shorter Al. The regimen of 200 mu g oral misoprostol at 6-hour intervals following a 200 ug or 400 mu g priming vaginal dose is feasible and efficacious for second trimester pregnancy termination. Copyright (C) 2015, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.