Role of Corticosteroids in Shortening the Duration of Medical Induction of Abortion in Mid-Trimester Pregnancy Loss
Eman Mosa Ashmawy Attia;
Abstract
Second trimester, or mid-trimester, is a period ranging from 13 to 28 weeks of gestation, which again is subdivided into an early period between 13 and 20 weeks and a late period between 20 and 28 weeks. Second trimestericabortion constitute 10–15% of all induced abortions worldwide and are responsible for two-thirds of major abortion-related complications (Ngai et al., 1997).
Glucocorticoids, like other steroids are lipophilic and readily access their intracellular receptors (Seckl and Walker, 2001). They are involved in both maturation of the fetal lung and parturition via stimulation of surfactant formation in the fetal lung and prostaglandin synthesis in human intrauterine tissues, respectively (Li et al., 2006).
In this study, we aimed to show safety and efficacy of intramuscular injection of dexamethasone with vaginal misoprostol forshortening theinduction – abortion intervalin thesecond trimester of pregnancy.
This study was conducted in Ain Shams Maternity University Hospital where 120 pregnant females were included for induction of second trimester abortion. They were divided into two groups each one of 60 female. One group received 12 mg dexamethasone intramuscular injection with onset of the medical induction of abortion by misoprostol and the other group received 3ml distilledwater instead ofdexamethasone.
In this study, both groups were demographically similar regarding (maternal age, gestational age, parity and BMI), there was no significant statistical difference.
There was no significant difference between both groups as regard number of previous second trimester abortions and timing of abortion.
From the current study there were significant differences as regards the induction-abortion interval and the length of hospital stay between both groups. Also there was significant difference between both groups as regard doses of misoprostol, where it was lower in the dexamethasone than that of the placebo group.
As regard need for second cycle of misoprostol, there was no significant difference between both groups. Although the study concluded that there was increase in use of second cycle of doses of misoprostol in the placebo group but the results was not enough to besignificantly different.
Need for surgical evacuation and estimated blood losswere not significantly different between both groups. There were no significant differences as regards fever, endometritisand use of antibiotics between both groups, although the number of women had fever and endometritis and used antibiotics were less in the dexamethasone group. No cases ofblood transfusion, hystrotomy, hysterectomy or DIC were reported in both groups.
The results suggested that use of intramuscular injection ofdexamethasone with misoprostol was effective inshortening the induction- abortion interval, the length of hospital stay and reducing the misoprostol doses.
Glucocorticoids, like other steroids are lipophilic and readily access their intracellular receptors (Seckl and Walker, 2001). They are involved in both maturation of the fetal lung and parturition via stimulation of surfactant formation in the fetal lung and prostaglandin synthesis in human intrauterine tissues, respectively (Li et al., 2006).
In this study, we aimed to show safety and efficacy of intramuscular injection of dexamethasone with vaginal misoprostol forshortening theinduction – abortion intervalin thesecond trimester of pregnancy.
This study was conducted in Ain Shams Maternity University Hospital where 120 pregnant females were included for induction of second trimester abortion. They were divided into two groups each one of 60 female. One group received 12 mg dexamethasone intramuscular injection with onset of the medical induction of abortion by misoprostol and the other group received 3ml distilledwater instead ofdexamethasone.
In this study, both groups were demographically similar regarding (maternal age, gestational age, parity and BMI), there was no significant statistical difference.
There was no significant difference between both groups as regard number of previous second trimester abortions and timing of abortion.
From the current study there were significant differences as regards the induction-abortion interval and the length of hospital stay between both groups. Also there was significant difference between both groups as regard doses of misoprostol, where it was lower in the dexamethasone than that of the placebo group.
As regard need for second cycle of misoprostol, there was no significant difference between both groups. Although the study concluded that there was increase in use of second cycle of doses of misoprostol in the placebo group but the results was not enough to besignificantly different.
Need for surgical evacuation and estimated blood losswere not significantly different between both groups. There were no significant differences as regards fever, endometritisand use of antibiotics between both groups, although the number of women had fever and endometritis and used antibiotics were less in the dexamethasone group. No cases ofblood transfusion, hystrotomy, hysterectomy or DIC were reported in both groups.
The results suggested that use of intramuscular injection ofdexamethasone with misoprostol was effective inshortening the induction- abortion interval, the length of hospital stay and reducing the misoprostol doses.
Other data
| Title | Role of Corticosteroids in Shortening the Duration of Medical Induction of Abortion in Mid-Trimester Pregnancy Loss | Other Titles | دور الكورتيزون في تقصير مدة التحريض الطبي للإجهاض في الثلث الثاني من الحمل | Authors | Eman Mosa Ashmawy Attia | Issue Date | 2015 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.