Medically induced abortion in second trimester with intravaginal misoprostol

Prostaglandins are more and more used for second trimester pregnancy termination. Their preferential application is vaginal and because the intracervical variant is laborious and invasive, the posterior vaginal fornix became increasingly used and investigated. Misoprostol is an E-1 prostaglandin synthetic analog with an innocuity equivalent to that of E-2 prostaglandin, but doubled by an increased efficiency and a lower cost. This study is intended to extend the existent experience regarding the intravaginal misoprostol for second trimester therapeutic abortion induction. This prospective clinic study selected 20 pregnant women, with a gestational age of 15 to 27 weeks who have been checked in the Clinic of Obstetrics-Gynecology of the University of Medicine and Pharmacy of Craiova, for therapeutic abortion induction. The 20 pregnant women received in PVF a 200 mu g misoprostol tablet each 12 hours, respecting strictly the protocol developed by the authors. Our results demonstrate clearly that in the conditions of therapeutic correction/counteraction of the complications associated to pregnancies that must be terminated in the second trimester, the rate of abortion in the first 24 hours from the intravaginal misoprostol application (following the protocol developed by the authors) can become 100%, while the average duration of the abortion induced in the same manner drops to under 12 hours. Our observations indicate a rate of complete abortion of 60%, which reduced significantly the rate of postabortum curettage. in the same time opening new perspectives to fetal transplantation and noninvasive investigation of the amniotic fluid. So, the misoprostol applied in the posterior vaginal fornix following the protocol elaborated by us is a physiological, practical and effective method if it adapts to the particularities of the case as dose and timely associated therapy.