RELATION BETWEEN CERVICAL LENGTH AND DURATION OF SECOND TRIMESTER PREGNANCY TERMINATION

Abstract

Fetal demiseTreatment options for early pregnancy failure include expectant management, medical completion, and surgical evacuation in either an office or operative suite. Medical abortions in the second trimester are widely employed worldwide, especially where surgical expertise is not available. So, if surgical expertise for second trimester abortion is not available, medical abortion with misoprostol with or without mifepristone should be offered. The success of induction depends on several factors that some literatures proved their association with success and others excluded their association like maternal age, height, weight, induction of abortion causes, gestational age, and cervical status including its digital parameters (consistency, position, length, dilatation, effacement), and its ultrasonographic parameters (length and funnelling are the most important). The limiting factor in digital examination is the inherent variability associated with assessing criteria other than dilation, but its advantage is that it evaluates cervical consistency and station, which may influence the outcome; it also requires less equipment. On the other hand, trans-vaginal ultrasound measurement of cervical length provides a more objective measurement. Many authors have tried to assess digital examination, trans-vaginal ultrasound, and both together aiming at evaluation of each of them as a method of prediction of labour induction concerning about their accuracy, tolerability, and availability. But none had studied their effect on the induction of mid-trimesteric abortion. This study is one of the first studies discussing this issue. Some studies supposed that trans-vaginal ultrasonographic measurement of cervical length does not add any additional benefit to the prediction of cervical inducibility obtained by cervical assessment. Also, other studies recommended that digital assessment was a superior method for prediction of successful labour induction than to the use of ultrasonographic measured cervical length. In our current study, digital assessment and trans-vaginal ultrasonographic assessment were done in 75 women with second trimesteric abortion before induction of abortion.