Update on second trimester medical abortion

  title={Update on second trimester medical abortion},
  author={Klaira Lerma and Kate A. Shaw},
  journal={Current Opinion in Obstetrics and Gynecology},
  • K. Lerma, K. Shaw
  • Published 1 December 2016
  • Medicine
  • Current Opinion in Obstetrics and Gynecology
Purpose of review To review recent literature on second trimester abortion with medical methods. Recent findings Across studies published in the recent past, it is apparent that women prefer shorter procedures and procedure times. Several randomized controlled trials have confirmed adding mifepristone to the second trimester medication abortion regimen results in shorter abortion intervals from first misoprostol administration to complete fetal expulsion. A study of simultaneous administration… 

Dosing interval between mifepristone and misoprostol in second and third trimester termination

A 1 day interval between mifepristone and misoprostol is more effective in second and third trimester TOP compared to other strategies in terms of reducing the induction to abortion interval.

A prospective study of mifepristone and unlimited dosing of sublingual misoprostol for termination of second-trimester pregnancy in Uzbekistan and Ukraine

Medical abortion in pregnancies of 13–22 weeks with 200 mg mifepristone followed 24–48 hours later by 400 μg sublingual misoprostol administered every 3 hours until complete expulsion is effective, safe and acceptable to women is found.

Induction of labour in mid-trimester pregnancy using double-balloon catheter placement within 12 hours versus within 12-24 hours

Considering the cervical condition is immature in the mid-trimester, properly extending the placement time of DBC to 24 hours will benefit for cervical ripening and lead to reduce chance of dilatation and evacuation.

Induction of labour in mid-trimester pregnancy using double-balloon catheter placement within 12 h versus within 12–24 h

Considering that the cervical condition is immature in the mid-trimester, properly extending the placement time of DBC to 24 h will benefit cervical ripening and reduce the chance of dilation and evacuation.

Contribution of pelvic hot shower therapy to effectiveness in 2nd trimester medical abortions (Balsak's hot shower technique)

Preliminary results suggest that pelvic hot shower application is an accessible, applicable, simple, effective, and inexpensive beneficial method for patients in the induced 2nd trimester.

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Update on second-trimester surgical abortion

The use of mifepristone and misoprostol for second-trimester abortion has improved safety and efficacy of medical and surgical methods when used alone or in combination and as adjuncts to osmotic dilators.

Mifepristone–Misoprostol Dosing Interval and Effect on Induction Abortion Times: A Systematic Review

Shortening the mifepristone–misoprostol interval, thereby reducing total abortion time, does not compromise the safety or efficacy of second-trimester medication abortion and may be used to accommodate patient or health care provider preference.

Mid-trimester induced abortion: a review.

The aim of this article is to provide a review of the current literature of mid-trimester methods of abortion with respect to efficacy, side effects and acceptability and to highlight the need for randomized studies to set guidelines for mid- Trimester abortion methods in terms of safety and acceptance as well as for better analgesic regimens.

Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia

The medical abortion regimen of 200 mg mifepristone followed by induction with 400 μg buccal misoprostol administered every 3 h, with no limit on the number of doses used for the termination of pregnancies of 13–22 weeks’ gestation is an effective and acceptable option for women.

Simultaneous Administration Compared With a 24-Hour Mifepristone–Misoprostol Interval in Second-Trimester Abortion: A Randomized Controlled Trial

Administering mifepristone and misoprostol simultaneously results in lower expulsion rates within 24 hours of taking misOProstol, longer median misop frostol treatment times, and requires more misopostol doses.

Mifepristone and Misoprostol Compared With Misoprostol Alone for Second-Trimester Abortion: A Randomized Controlled Trial

Services offering home administration of mifepristone as pretreatment could optimize efficacy and acceptability of medical abortions for women with gestations 14–21 weeks since the last menstrual period.

Surgical versus medical methods for second trimester induced abortion.

Dilation and evacuation is superior to instillation of prostaglandin F(2) (alpha) and the current evidence also appears to favour D&E over mifepristone and misoprostol, however larger randomised trials are needed.

Mifepristone and Oral, Vaginal, or Sublingual Misoprostol for Second-Trimester Abortion: A Randomized Controlled Trial

Vaginal or sublingual misoprostol administered after a vaginal loading dose in second-trimester medical abortion with mifepristone priming is associated with a shorter time to pregnancy termination compared with an oral regimen.