Prostaglandin E1 versus Intrauterine Catheter for Termination of Pregnancy in Patients with Previous Cesarean Section

Document Type : Original Article

Authors

1 Sohag

2 obstetrics and gynecology department sohag university hospital

3 obstetric and gynecology department faculty of medicine sohag university

10.21608/smj.2025.435357.1622

Abstract

Background: Safe and effective methods of pregnancy termination are essential in women with previous cesarean sections (CS),though this issue was debatable for many decades and international guidelines didn’t reach to sharp recommendations about the safe methods for termination of pregnancy in those critical group of patients , given the increased risk of complications. This study compared prostaglandin E1 analogue (misoprostol) and intrauterine catheter for termination of the pregnancy, and sought to establish specific dosing regimens and intervals for misoprostol.

Methods: This prospective, randomized, controlled trial enrolled 400 women aged 20–40 years with gestational ages of 11–18 weeks and a history of at least one CS or intrauterine surgery. Participants were randomized 1:1 to receive either transcervical Foley catheter or misoprostol. For pregnancies ≤12 weeks, misoprostol was given as an initial 400 µg dose (by vaginal route), repeated every 3 hours if required. For 13–18 weeks, 200 µg was administered every 3 hours until expulsion these doses are according to FIGO 2023.

Results: In the misoprostol group, the mean number of doses was 5.3 ± 2.41, with the vaginal route . No significant differences were found in bleeding or transfusion needs. However, both time of occurrence of abortion and failure of the procedure were significantly lower in the misoprostol group compared with intrauterine catheter (P < 0.001). Retained placenta was also less frequent with misoprostol (P = 0.002).

Conclusions: Misoprostol is more effective and safer than intrauterine catheter for termination in women with scarred uterus,

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Sohag Medical Journal
Volume 30, Issue 1
Clinical Science Volume
2026
Pages 1-7

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