Outcomes of Pregnancy Termination by Misoprostol at 14-32 Weeks of Gestation: A 10-Year-Experience
Saipin Pongsatha MD*, Theera Tongsong MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To review outcomes of pregnancy termination between 14-32 weeks of gestation based on a10-year-experience of
misoprostol use at Maharaj Nakorn Chiang Mai Hospital.
Study design: A retrospective, descriptive study
Material and Method: Based on the authors’ prospective database, all pregnancy terminations by misoprostol between
14-32 weeks of gestation between 1998 and 2008 were reviewed. The main outcomes included success rate of termination,
mean induction-to-abortion time, and complication rate. In addition, regimens and routes of drug administration as well as
indications for termination of pregnancy were also analyzed.
Results : Seven hundred forty one pregnancy terminations were performed using misoprostol with dosage varied from 50 mcg
to 800 mcg, mostly 400 mcg intravagina every three hours. The most common indication for pregnancy termination was
severe fetal thalassemia (35.8%). The majority of cases were pregnancies with live fetuses and only 18.2% were associated
with a dead fetus in utero. Success rate of termination within 48 hours was 85.9%. Pregnancies with previous cesarean
section accounted for 8.6% of cases. The mean gestational age was 20.94 weeks. The mean abortion time was 25.35 hours,
ranging from 1.25 to 247.88 hours. The two most common adverse effects were chill and fever (43.7% and 34.3%). The rate
of analgesia needed was 39.3%. No serious adverse complications such as uterine rupture were found.
Conclusion : This experience suggests that misoprostol has a high efficacy for pregnancy termination with acceptable minor
side effects and it is relatively safe when used with precaution.
Keywords : Misoprostol, Pregnancy termination, Abortion time
