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Review
. 2011 Jan;283(1):1-5.
doi: 10.1007/s00404-010-1561-7. Epub 2010 Jul 1.

Misoprostol and termination of pregnancy: is there a need for ultrasound screening in a general population to assess the risk for adverse outcome in cases of uterine anomaly?

N M van der Veen  1 , J F G M Brouns, J P Doornbos, W J van Wijngaarden
Affiliations
Review

Misoprostol and termination of pregnancy: is there a need for ultrasound screening in a general population to assess the risk for adverse outcome in cases of uterine anomaly?

N M van der Veen et al. Arch Gynecol Obstet. 2011 Jan.

Abstract

Purpose and methods: We reviewed the existing literature on medical termination of pregnancy in cases of congenital uterine malformation. Is medical termination of pregnancy safe in the presence of a uterine anomaly? Can termination of pregnancy still be performed when information concerning the presence of congenital uterine malformation is not available?

Results: The risk of adverse outcome, i.e. uterine rupture, was high in class 2 uterine anomalies, whereas the risks in classes 3-6 were negligible. However, the very low incidence of class 2 anomalies in pregnant women results in a calculated risk of uterine rupture in medical termination of pregnancy on the basis of this anomaly of 1 in 300,000 pregnancies. Ultrasound scanning is of limited diagnostic value to diagnose congenital uterine malformations.

Conclusions: The implications of uterine anomalies are not an argument in the discussion whether to use misoprostol for termination of pregnancy in developing countries with scarce diagnostics tools.

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Figures

Fig. 1
Fig. 1
Classification of congenital uterine anomalies according to the American Fertility Society “AFS” (1988)
Fig. 2
Fig. 2
Distribution of uterine anomalies [8]
Fig. 3
Fig. 3
Prevalence of uterine anomalies in fertile women
See this image and copyright information in PMC

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