Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy

Objectives: To examine the effectiveness, safety and acceptability of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. Methods: This clinical study was conducted on 90 pregnant patients intended for termination of pregnancy between 13 and 24 gestational weeks for any indication. Enrolled women are equally allocated into three groups: Group I (Misoprostol group): a standard regimen of moistened misoprostol (400 mg) 4 hourly inserted vaginally. Group II (Catheter group): intracervical Foley catheter inserted, inflated and placed on traction. Group III (Combined group): intracervical Foley catheter inserted with a standard regimen of moistened misoprostol (400 mg) 4 hourly intravaginally was used. Procedure efficacy (defined as complete abortion performed on site), safety and acceptability were assessed. Results: The induction to abortion interval was 7.5 +/- 1.25 h in the combined group, compared to 11.76 +/- 1.63 h in the misoprostol group and 19.76 +/- 1.52 h in the catheter group (p value < 0.001) with a success rate of 100% and no major complications reported. Conclusions: The present results confirmed the high success rate with the shortest induction to abortion interval with a combined use of intracervical Foley catheter and misoprostol for termination of second trimester pregnancy.