EP21.08: Misoprostol abortion in mothers with and without history of Caesarean

This study aims to investigate the complications due to misoprostol administration for pregnancy termination among women with and without history of Caesarean section. The cohort of this retrospective study included 280 patients who required medical abortion from 2021 to 2022 in Taleqani Hospital in Iran and treated with vaginal misoprostol of 200 to 1600 μg. The subjects were divided into 2 groups based on their history of Caesarean sections: first group included 97 patents with history of Caesarean section, and second group include 183 patients without history of Caesarean section or uterine scarring. The results showed that the success rate of misoprostol administration for pregnancy termination was 41% in first group and 67% in second group. Need for curettage due to retained tissue of conception was significantly higher in participants with history of Caesarean section. But the rate of life threatening bleeding and rupture of uterus as a complications of medical abortion with misoprostol was not significantly different between first and second groups. There was a significant relationship between the need for other auxiliary treatments in the pregnancy termination and the history of uterine scarring. History of Caesarean section was not associated with higher morbidity except need for surgical procedure due to higher rate of retained tissue after medical abortion of pregnancy. However, dose and interval of misoprostol should be determined.