The Outcomes of Second Trimesteric Induction of Abortion in Previously Scarred Uterus at Ain Shams Maternity Hospital

Abstract Back Ground Termination of pregnancy by induced abortion is one of the commonest procedures, Pregnancy termination in case with prior cesarean delivery becomes an increasingly common situation facing obstetricians due to progressive increase in the rate and incidence of cesarean births. The aim of the Study was to assess and evaluate the outcomes of second trimesteric induction of abortion in previously scarred uterus. Methods this was a retrospective study curried at Ain Shams Maternity Hospital at the period from the 1st of January 2018 till the 31st of December 2020. Results Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy (median [IQR] = 1100 [800 – 2400] mg versus 800 [500 – 1600] mg, respectively; p= .047). Conclusion There were 15.5% suffered failed medical abortion and 1.5% rupture uterus with difficulty to correlate this event to the dose of the medication used for induction. Increased gestational age, history of 3 or more CS, and presence of > 1 gestational sac was independently associated with decreased probability of successful medical abortion. Higher total dose of misoprostol was only marginally associated with decreased probability of success. On the other hand, higher hemoglobin level is independent predictor of successful medical abortion. Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy.