Comparative study of oral misoprostol versus vaginal misoprostol for induction of second trimesteric abortion

The aim of this work was to compare the safety and efficacy of oral misoprostol with that of vaginal misoprostol for termination of second trimester pregnancy. one hundred twenty women requiring second trimester pregnancy termination were randomly allocated to receive either oral or vaginal misoprostol 400 ug/8 hours, this dose was used for 24 hours after which the attending physician was allowed to either increase dose, decrease frequency of dosing, change route of misoprostol use or use oxytocin, the two groups were comparable with respect to maternal age, parity, indication of abortion and gestational age. Compared with women receiving oral misoprostol, a greater percentage of women receiving vaginal misoprostol aborted within 24 hours [88.33% versus 66.66%]. The induction-abortion interval was significantly shorter in vaginal group [18 +/- 15.5 hours versus 32 + 18 hours, P < 0.001]. Complications namely nausea, vomiting, fever and severe pain were significantly higher in oral misoprostol group. 7 cases [11.66%] in group 1 [Oral misoprostol] shift to vaginal misoprostol after failure to abort within 24 hours from the start of induction. The need for oxytocin augmentation was significantly higher in-group 1[oral misoprostol]. Compared with oral misoprostol, vaginal misoprostol resulted in shorter induction to abortion interval, shorter duration of hospital stay and less side effects from misoprostol

Role of activated protein C resistance in recurrent second trimester abortion

The aim of this work was to determine if the prevalence of activated protein C resistance [APCR] is higher in women with recurrent second trimester pregnancy loss. Study design: A prospective study carried out on 120 women in Kasr El-Aini in the period from January 1999 to March 2000, detailed history, clinical examination and assessment of APCR was carried out for all women on the study. Women were divided into three groups, 40 women with a previous history of two or more first trimester abortions 3, 40 women with a previous history of two or more second trimester pregnancy loss and 40 healthy multiparous women with no previous history of abortion as a control group. The prevalence of activated protein C resistance [APCR] was significantly higher amongst women who had second- trimester abortion [12/40: 30%] compared with women who had experienced only first trimester abortion [4/40: 10%] and the controls [2/40: 5%]. Also, this study has shown that there was a significant difference as regards normalized ratio of activated protein C-sensitivity ratio [n-APC-SR]. Tests for APC resistance should be considered in cases of recurrent second trimester pregnancy loss, despite absence of previous thrombotic medical history