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The problem of second trimester pregnancy termination

HEALTH OF WOMAN.2015.7(103):28–30 
 

The problem of second trimester pregnancy termination 
 

Babenko O. M.

The medical center "INGO", Kyiv 
 

According to foreign literature proportion of second trimester abortions is 10-15% of all pregnancy terminations, while they are responsible for virtually all cases of severe maternal morbidity and mortality associated with this procedure. Until recently, in the world was absent a method which would be highly effective and safe for the health of women. The situation has changed with the development such drugs as mifepristone and misoprostol. In the article were compiled data from recent international researches on this issue to facilitate the work of obstetrician and gynecologist, to improve the quality of care and to prevention of serious complications.

Key words: pregnancy, second trimester, abortion, misoprostol, mifepristone. 
 

REFERENCES

1. Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. 6th ed. Geneva, World Health Organization, 2011

2. Lohr PA, Hayes JL, Gemzell-Danielsson K. 2008. Surgical versus medical methods for second trimester induced abortion. Cochrane Database of Systematic Reviews 1: CD006714. http://dx.doi.org/10.1002/14651858.cd006714.pub2

3. South Africa. Department of Health. Termination of pregnancy update: cumulative statistics through 2004. Pretoria: Department of Health. 2005

4. Berer M. 2008. Second trimester abortion: public policy, women’s health. Editorial. Reproductive Health Matters. 16(31):3–13. http://dx.doi.org/10.1016/S0968-8080(08)31395-0

5. International Conference on Second Trimester Abortion. Conference Report. 29–31 March 2007. London.

6. Tuyet Hoang TD, Thuy Phan, Trang Huynh NK. 2008. Second trimester abortion in Viet Nam: changing to recommended methods and improving service delivery. Reproductive Health Matters 16(31):145–150. http://dx.doi.org/10.1016/S0968-8080(08)31393-7

7. Ingham R, Lee E, Clements SJ et al. 2008. Reasons for second trimester abortions in England and Wales. Reproductive Health Matters 16(31):18–29. http://dx.doi.org/10.1016/S0968-8080(08)31375-5

8. Ustб MB, Mitchell EMH, Gebreselassie H et al. 2008. Who is excluded when abortion access is restricted to twelve weeks?: evidence from Maputo, Mozambique. Reproductive Health Matters 16(31):14–17.

9. Font-Ribera L, Pйrez G, Espelt A et al. 2009. Determinants of induced abortion delay. Gaceta sanitaria. S.E.S.P.A.S. 23(5):415–419.

10. Loeber O, Wijsen C. 2008. Factors influencing the percentage of second trimester abortions in the Netherlands. Reproductive Health Matters 16(31):30–36. http://dx.doi.org/10.1016/S0968-8080(08)31377-9

11. Harries J, Orner P, Gabriel M et al. 2007. Delays in seeking an abortion until the second trimester: a qualitative study in South Africa. Reproductive Health 4:7. http://dx.doi.org/10.1186/1742-4755-4-7; PMid:17883835 PMCid:PMC2039724

12. Drey EA, Foster DG, Jackson RA et al. 2006. Risk factors associated with presenting for abortion in the second trimester. Obstetrics & Gynecology 107(1):128–135. http://dx.doi.org/10.1097/01.AOG.0000189095.32382.d0; PMid:16394050

13. Кулаков ВИ, Серов ВН, Барашнев ЮИ. 2000. Проблема аборта. Руководство по безопасному материнству. М:449–468.

14. Корхов ВВ, Абрамченко ВВ, Башмакова МА. 2000. Антибиотики в акушерстве и гинекологии. Руководство для врачей. СпецЛит.:158–162.

15. Абрамченко В.В. 2003. Простагландины и антигестагены в акушерстве и гинекологии. Петрозаводск. ИнтелТек.:207.

16. Акулич ТИ, Книга ГЕ. 1981. О сроках и методах искусственного прерывания беременности. Актуальные проблемы гинекологии. Минск:90–96.

17. Гатина ГА, Кузьмина ТИ, Соловьева АД, Бакулева ЛП. 1990. Искусственное прерывание беременности в поздние сроки по медико-генетическим показаниям. Акуш. и гин. 9:34–37.

18. Гуляева Л.C. 1998. Перспективы прерывания беременности в поздние сроки. Актуальные вопросы акушерства и гинекологии. Минск:26–28.

19. Кулаков ВИ, Зак ИР, Куликова НА. 1987. Аборт и его осложнения. М:155.

20. Винклер КЛ, Грей СИ, Хаут Дж.К и соавт. 1991. Индукция аборта во втором триместре: концентрированный окситоцин в сравнении с вагинальными суппозиториями простагландина E2. Акушерство и гинекология 77(2):297–300.

21. Safe abortion: technical and policy guidance for health systems – World Health Organization. 2003.

22. Siebert JR, Kapur RP, Resta RG, Luthy D. 2005. Methods for induced abortion. letter. Obstetrics and Gynecology 105:221. http://dx.doi.org/10.1097/01.AOG.0000149160.40899.dahttp://dx.doi.org/10.1097/01.AOG.0000145753.05624.62; PMid:15625178

23. Medical methods for termination of pregnancy. WHO Technical Report Series. Geneva: World Health Organization. 1997:871.

24. Lawson HW, Frye A, Atrash HK et al. 1994. Abortion mortality, United States, 1972 through 1987. American Journal of Obstetrics and Gynecology 171:1365–1372. http://dx.doi.org/10.1016/0002-9378(94)90162-7

25. Grimes DA. 1984. Second-trimester abortion in the United States. Family Planning Perspectives 16:260–266. http://dx.doi.org/10.2307/2134915; PMid:6519237

26. Safe abortion: technical and policy guidance for health systems – 2nd ed. World Health Organization. 2012.

27. Lohr PA, Hayes JL, Gemzell-Danielsson K. 2008. Surgical versus medical methods for second trimester induced abortion. Cochrane Database of Systematic Reviews 1. Art. No.: CD006714. http://dx.doi.org/10.1002/14651858.CD006714.pub2; PMid:18254113

28. Cheng L. Сравнение хирургических и медикаментозных методов индуцированного аборта во втором триместре: Комментарий БРЗ (последняя редакция: 1 ноября 2008 года). Библиотека репродуктивного здоровья ВОЗ. Женева. Всемирная организация здравоохранения.

29. Наказ МОЗ України від 31.12.2010 № 1177 «Про затвердження клінічного протоколу «Комплексна допомога під час небажаної вагітності».

30. Clinical practice handbook for Safe abortion. 2014. WHO Press, World Health Organization. Geneva.

31. Wildschut H et al. 2010. Medical methods for mid-trimester termination of pregnancy. Cochrane Database of Systematic Reviews. Art. 2:CD005216.

32. Pluchon M, Winer N. 2014. Misoprostol in case of termination of pregnancy in the second and third trimesters. Trials. J Gynecol Obstet Biol Reprod. Paris. 43(2):162–168. http://dx.doi.org/10.1016/j.jgyn.2013.11.009; PMid:24440001

33. Yazdani SH, Zeinalzadeh M, Bouzari Z, Golsorkhtabar-Amiri M. 2012. Effects of vaginal versus oral misoprostol to terminate second-trimester pregnancy. Clin Exp Obstet Gynecol. 39(4):529–531. PMid:23444761

34. Dickinson JE, Jennings BG, Doherty DA. 2014. Mifepristone and oral, vaginal, or sublingual misoprostol for second-trimester abortion: a randomized controlled trial. Obstet Gynecol. 123(6):1162–1168. http://dx.doi.org/10.1097/aog.0000000000000290

35. Pongsatha S, Tongsong T. 2014. Randomized controlled trial comparing efficacy between a vaginal misoprostol loading and non-loading dose regimen for second-trimester pregnancy termination. J Obstet Gynaecol Res. 40(1):155–160. http://dx.doi.org/10.1111/jog.12147; PMid:24033985

36. Kulkarni Kranti K. 2014. Pre-induction with Mifepristone for Second Trimester Termination of Pregnancy. The Journal of Obstetrics and Gynecology of India 64;2:102–104. http://dx.doi.org/10.1007/s13224-013-0472-5; PMid:24757336 PMCid:PMC3984646

37. Tripti N, Namrata S. 2011. Misoprostol Vs Mifepristone and Misoprostol in Second Trimester Termination of Pregnancy. The Journal of Obstetrics and Gynecology of India 61(6):659–662. http://dx.doi.org/10.1007/s13224-011-0118-4; PMid:23204686 PMCid:PMC3307930

38. Toptas T, Mendilcioglu I, Simsek M, Taskin. 2014. Intravaginal misoprostol alone versus intravaginal misoprostol and extraamniotic Foley catheter for second trimester pregnancy termination: an observational study. Ginekol Pol. 85 (8):577–581. http://dx.doi.org/10.17772/gp/1774

39. Rasmussen AL, Frostholm GT, Lauszu FF. 2014. Curettage after medical induced abortions in second trimester. Sex Reprod Healthc. 5(3):156–157. http://dx.doi.org/10.1016/j.srhc.2014.06.002; PMid:25200978

40. Ka Wang Cheung, Siew-Fei Ngu, Vincent YT Cheung. 2015. Sonographic Characteristics of the Uterus in Asymptomatic Women After Second-Trimester Medical Termination of Pregnancy. J Ultrasound Med. 34:611–616. http://dx.doi.org/10.7863/ultra.34.4.611; PMid:25792576

41. Mдnnistц J, Mentula M, Bloigu A et al. 2014. Medical termination of pregnancy during the second versus the first trimester and its effects on subsequent pregnancy. Contraception. –89(2):109–115. http://dx.doi.org/10.1016/j.contraception.2013.10.015; PMid:24332746

42. Gьleз U. Kьзьkgцz, Urunsak IF, Eser E et al. 2013. Misoprostol for midtrimester termination of pregnancy in women with 1 or more prior cesarean deliveries. Int J Gynaecol Obstet. 120(1):85–87. http://dx.doi.org/10.1016/j.ijgo.2012.08.013; PMid:23195293