Induced second trimester abortion by extraamniotic prostaglandin infusion in patients with a cesarean scar: is it safe?

Background. One result of the advancement in prenatal diagnosis is an incre ase in the need for second trimester pregnancy terminations. Extra-amniotic infusion of prostaglandins is a common technique used for such pregnancy t ermination. Since prostaglandins cause strong nn uterine contractions, many practitioners are hesitant to use this technique on women with a uterine s car. In this study we tried to evaluate the effectiveness and safety of the technique for women with a previous uterine scar. Methods. This retrospective study included all women with a complete medica l record who underwent a second trimester pregnancy termination at our inst itution by extra amniotic prostaglandin E2, during a 6 year period. The stu dy group included all women with a previous uterine scar. The group of wome n without such a scar served as the control group. Results. Three hundred and forty women had their pregnancy terminated, but only in 282 cases was the medical information complete (research population ). The study group (35 women) characteristics were similar to those of the control group (247 women). We found no difference in the abortion interval, the need to use an additional method, the need for curettage and in bleedi ng complication between the two groups. There was no case of uterine ruptur e. The group of women with multiple uterine scars was too small for analysi s. Conclusions. Our results suggest that extra amniotic prostaglandin infusion is an effective and safe technique in women with a uterine scar.