TERMINATION OF PREGNANCY

THERAPEUTIC TERMINATION OF PREGNANCY IN SECOND TRIMESTER.

Abstract

Objectives: To compare efficacy of extra-amniotic Foley’s catheter balloon alone
versus combined use of Foley’s catheter balloon and extra-amniotic instillation of prostaglandin
F2-alpha in therapeutic termination of second trimester pregnancy. Study Design: Randomized
controlled trial. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital,
Bahawalpur. Period: Two years. July 2014 to June 2016. Sample Technique: Non-probability,
consecutive sampling technique. Patients & Methods: A total of 256 patients, 16 to 38 years of
age with fetal death or missed abortion on ultrasonography in 2nd trimester (14-24 gestational
weeks) of pregnancy were included in the study. Patients with previous uterine surgery, multiple
pregnancies and parity>3 were excluded. Then selected patients were placed randomly into
two groups i.e. Group A (extra-amniotic Foley’s catheter balloon alone) & Group B (Foley’s
catheter balloon along with extra-amniotic instillation of prostaglandin F2-alpha), by using lottery
method. Outcome variables like efficacy i.e. expulsion of fetus within 24 hours of induction, were
noted. Results: The mean age of women in group A was 24.51 ± 4.77 and in group B was 24.29
± 4.48 years. The mean gestational age in group A was 21.65 ± 2.01 weeks and in group B
was 21.28 ± 1.93 weeks. Efficacy was 103 (80.47%) in group A (extra-amniotic Foley’s catheter
balloon alone) and 119 (92.97%) in group B (combined use of Foley’s catheter balloon and
extra-amniotic instillation of prostaglandin F2-alpha) with p-value of 0.003. Conclusion: This
study concluded that combined use of Foley’s catheter balloon and extra-amniotic instillation
of prostaglandin F2-alpha is better and more efficacious than extra-amniotic Foley’s catheter
balloon alone in therapeutic termination of second trimester pregnancy.