Özet
Amaç. Bu çalışmanın amacı ilk trimesterde gebelik sonlandırması öncesi servikal olgunlaşma için kullanılan iki farklı misoprostol uygulamasının etkinliğini karşılaştırmaktır. Yöntem. Gebelik sonlandırılması kararı verilen 18-42 yaş grubunda 167 kadın değerlendirmeye alınmıştır. Grup 1 içerisinde yer alan 102 hastaya 4 saat ara ile 100 µg oral ve 100 µg vajinal misoprostol, grup 2 içerisinde yer alan 65 kadın hastaya 6 saat ara ile 200 µg oral ve 200 µg vaginal misoprostol uygulanmıştır. Sistemik hastalığı olanlar, servikal operasyon geçirenler, gebeliğinde kanaması olanlar ve bazal servikal açıklığı 4 mm'den fazla olanlar çalışma dışında bırakılmıştır. Ulaşılan servikal açıklık, düşük süresi, yan etkiler ve diğer başlangıç klinik verileri toplandı. Bulgular. Çalışma grupları yaş, gravida, parite ve gebelik yaşı açısından benzerdi. Multipar kadınlarda grup 1'de bazal dilatasyon grup 2'ye göre anlamlı olarak daha yüksekti (p<0,05). Nullipar hastalarda son servikal açıklık ölçümleri grup 2'de grup 1'e göre anlamlı olarak daha yüksekti (p<0,05). Nullipar hastalarda düşük süresi grup 2'de grup 1'e gore anlamlı olarak daha uzundu (p<0,05). Bulantı, kusma ve ishal her iki grupta toplam 6 hastada gözlendi. Sonuçlar. İlk trimester gebelik sonlandırması yapılan nullipar hastalarda 4 saat ara ile uygulanan 100 µg oral ve 100 µg vaginal misoprostol önemli bir yan etkiye rastlanmaksızın yeterli servikal dilatasyonu sağlayabilir.
Anahtar sözcükler: Misoprostol, ilk trimester abortus, servikal olgunlaşma
Abstract
Aim: The aim of this study was to determine the efficacy of two protocols of misoprostol administration for cervical priming before first-trimester surgical abortion. Methods: A total of 167 women, aged 18-42 years, who decided to terminate their pregnancy were evaluated. One hundred two of them (group 1) were received 100 µg of misoprostol oral and 100 vaginal, doses repeated 4 hours later. Sixty five of them (group 2) were received 200 µg oral and 200 µg vaginal doses repeated 6 hours later. Exclusion criteria were systemic disease, a history of cervical operations, bleeding or spotting during the current pregnancy, basal cervical dilation greater than 4mm. Results. The age, gravidity, parity, and gestational age of study groups were comparable (p>0.05). For women with multiparity, the basal dilatation of group 1 was significantly higher than that of the group 2 (p<0.05). For women with nulliparity, the achieved dilatation of group 2 was significantly higher than that of the group 1 (p<0.05). For women with nulliparity, the abortion time of group 2 was significantly higher than that of the group 1 (p<0.05). Nausea, vomiting, and diarrhea were present only in six patients. Conclusion: Misoprostol administered as 100 µg of misoprostol oral and 100 vaginal, doses repeated 4 hours later provides adequate cervical dilation after an acceptable period in nullipar women undergoing first-trimester pregnancy termination without significant side effect.
Keywords: Misoprostol, first trimester abortion, cervical priming
Aim: The aim of this study was to determine the efficacy of two protocol of misoprostol administration for cervical priming before first-trimester surgical abortion. Methods: A total of 167 women, aged 18-42 years, who decided to terminate their pregnancy were evaluated. One hundred two of them (group 1) were received 100 µg of misoprostol oral and 100 vaginal, doses repeated 4 hours later. Sixty five of them (group 2) were received 200 µg oral and 200 µg vaginal doses repeated 6 hours later. Exclusion criteria were systemic disease, a history of cervical operations, bleeding or spotting during the current pregnancy, basal cervical dilation greater than 4mm. Results. The age, gravidity, parity, and gestational age of study groups were comparable (p>0.05). For women with multiparity, the basal dilatation of group 1 was significantly higher than that of the group 2 (p<0.05). For women with nulliparity, the achieved dilatation of group 2 was significantly higher than that of the group 1 (p<0.05). For women with nulliparity, the abortion time of group 2 was significantly higher than that of the group 1 (p<0.05). Nausea, vomiting, and diarrhea were present only in six patients. Conclusion: Misoprostol administered as 100 µg of misoprostol oral and 100 vaginal, doses repeated 4 hours later provides adequate cervical dilation after an acceptable period in nullipar women undergoing first-trimester pregnancy termination without significant side effect.
Birincil Dil | İngilizce |
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Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
Yazarlar | |
Yayımlanma Tarihi | 3 Kasım 2009 |
Yayımlandığı Sayı | Yıl 2009Cilt: 31 Sayı: 4 |