Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality

Objective Evaluation of factors influencing the duration of second-trimester pregnancy interruption With vaginal misoprostol for fetal abnormality. Methods All medical terminations >= 13 weeks of gestation 1/1997 to 12/2007 were prospectively identified. Cases receiving vaginal misoprostol 400 mu g 6-hourly were extracted from the database and outcomes reviewed. Results This consecutive case series comprised 1066 women. Median maternal age was 3 1 years [interquartile range (IQR) 26, 36] and 15.4% had at least one prior cesarean delivery. Principal indications for termination Were aneuploidy (37.6%), neural tube defects (15.9%) and cardiac anomalies (9.4%). Median gestation at termination was 19.5 weeks (IQR 17.9, 21). Median abortion interval was 16.1 h (IQR 12, 23.5). Lower maternal age (median duration 17.6 vs 15.2 vs 13.6 h, age < 30 vs 30-39 vs > 40 years, p < 0.001), nulliparity (median duration 19 vs 14.3 h, nulliparous vs parous, p < 0.001) and increasing gestation (median duration 13 vs 17.8 h. < 16 vs > 20 weeks, p < 0.001) were associated with abortion prolongation. Controlling for gestation, age and parity, apart from musculoskeletal abnormalities (associated with abortion prolongation, p = 0.03), the specific fetal anomaly did not influence duration. Conclusions Three factors: nulliparity, younger maternal age and increasing gestation. were associated with abortion prolongation. Apart from musculoskeletal abnormalities. the fetal anomaly had no impact on abortion duration. Copyright (C) 2009 John Wiley & Sons. Ltd.