AI Article Synopsis
- The study focuses on the effectiveness of misoprostol for medical termination of pregnancy (TOP) in late first and second trimesters, particularly addressing issues related to retained placental remnants.
- Nearly half of the patients who had medical TOP required additional curettage due to retained placenta, indicating a significant complication.
- There was no clear correlation found between patient or procedural characteristics and the risk of retained placental tissue, suggesting that factors like misoprostol dosage and the use of ultrasound post-delivery warrant further investigation.
Article Abstract
Objective: Termination of pregnancy (TOP) for medical reasons is regularly performed using misoprostol. Presence of placental remnants followed by curettage, frequently complicate the procedure. Aim of this analysis is to audit our current policy for medical termination in late first and second trimester, looking at the management of third stage.
Methods: A retrospective analysis of patient data was performed. Included were patients that underwent medical TOP in late first or second trimester. Patients were reviewed 6 weeks postdelivery. Characteristics of procedure, patient and pregnancy were analysed to determine factors associated with an increased risk of retained placenta/placental remnants.
Results: We included 175 patients. Eighty-five patients (48%) underwent curettage immediately after delivery because of retained placenta or because placental remnants were suspected. Nineteen patients (11%) underwent curettage at later stage. All tissue was examined microscopically for confirmation of placental tissue. Analysis of characteristics of procedure, patients and pregnancies did not identify factors associated with an increased risk of retained placenta or placental remnants.
Conclusion: A large number of immediate and late curettages was seen after medical TOP. Misoprostol-dose might play a role and the role of ultrasonographic assessment of the uterine cavity immediately post-placenta-delivery needs to be studied.
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| http://dx.doi.org/10.3109/14767058.2011.629257 | DOI Listing |
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