Clinical analysis of the regimens for terminating the second-trimester pregnancy in cesarean section women

J Matern Fetal Neonatal Med. 2023 Dec;36(2):2249187. doi: 10.1080/14767058.2023.2249187.

Abstract

Objective: To explore the suitable regimens of induced termination of second-trimester pregnancy in women with prior cesareans.

Methods: A total of 204 s-trimester pregnant women with prior cesareans at the Third Affiliated Hospital of Zhengzhou University from January 2019 to December 2020 were included in this retrospective study. Group A included pregnant women who were administered mifepristone with misoprostol, Group B included those administering mifepristone with misoprostol as well as a transcervical Cook double-balloon catheter, Group C included those receiving mifepristone with an intra-amniotic injection of ethacridine lactate, and Group D included those receiving mifepristone, transcervical Cook double-balloon catheter, and intra-amniotic injection of ethacridine lactate. Their characteristics, clinical outcomes, and complications among the four groups were compared.

Results: All women had similar profiles in maternal age, gravidity, and previous cesarean delivery (p > .05). There was no significant difference in successful abortion among the four groups (p > .05). Group C had a significantly shorter induction-to-abortion interval than Group D (p < .01). The blood loss after abortion at 2 h in Group B was much less than Group A (p < .05). It made a significant difference between Group B and Group D regarding the blood loss after abortion at 2 h (p < .01). With regard to total incidences of adverse reactions, there were much fewer in the group B than the group A (p < .05).

Conclusion: The four regimens are all effective for the termination of second-trimester pregnancy in women with prior cesareans. The use of transcervical Cook double-balloon could reduce the risks caused by misoprostol, and the combination of these is feasible to induce second-trimester pregnancy termination in women with prior cesareans.

Keywords: Second-trimester pregnancy termination; complication; outcome; prior cesarean; regimen.

MeSH terms

  • Cesarean Section*
  • Ethacridine
  • Female
  • Humans
  • Mifepristone
  • Misoprostol*
  • Pregnancy
  • Pregnancy Trimester, Second
  • Retrospective Studies

Substances

  • Ethacridine
  • Mifepristone
  • Misoprostol