Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester surgical abortion (12-16 weeks)

Abstract

Background: The purpose of this study was to determine the rate of serious adverse events (SAEs) occurring during early second trimester surgical abortion performed following the use of misoprostol alone for cervical preparation.

Study design: A retrospective review was undertaken of 6620 elective surgical abortions performed between 12 and 16 weeks estimated gestational age during a 68-month period following cervical preparation with misoprostol alone. Information was obtained from a computer-based practice management system.

Results: During the study period, four SAEs occurred: three uterine perforations and one case of hemorrhage secondary to placenta accreta. The perforation rate was 0.45 (95% CI=0.09-1.32) per 1000 abortions.

Conclusion: This review of our experience with surgical abortion performed from 12 to 16 weeks estimated gestational age following cervical preparation with misoprostol alone shows that the rate of SAEs, specifically uterine perforation, in this group was no greater than that previously reported in the literature.