Intravaginal gemeprost and second-trimester pregnancy termination in the scarred uterus

ObjectiveTo investigate the effectiveness and complication rate of intravaginal gemeprost, a prostaglandin E1 analogue, for second-trimester pregnancy termination in women with a scarred uterus.MethodsOf 439 women undergoing induced abortion between the 13th and the 23rd week of pregnancy, 67 had a scarred uterus because of 1 or more cesarean sections or myomectomy. All women received a 1 mg dose of gemeprost intravaginally every 3 h, up to 5 times over 24 h. Those who did not respond received further cycles of gemeprost treatment.ResultsThe rate of successful abortions among women with uterine scars was not different from that observed in the nulliparous controls, but previously vaginal delivery was associated with a shorter induction to abortion interval. The rate of severe complications did not differ between the groups, and was about 1%.ConclusionThe rate of complications following intravaginal administration of a PGE1 analogue for second-trimester pregnancy termination was similar in women with a scarred or unscarred uterus.