Abstract
Mid-trimester termination of pregnancy in individuals with a previous Caesarean section (CS) presents a heightened clinical challenge due to the risk of uterine scar complications, including rupture and hemorrhage. The combined regimen of mifepristone and misoprostol is a well-established method for medical termination; however, its safety and efficacy profile in patients with a uterine scar, particularly during the mid-trimester, remains a significant area of clinical concern and requires further evidence-based evaluation. The study was aimed to find out the outcome of mid trimester termination of pregnancy in previous caesarian section by combined mifepristone and misoprostol. This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Bangladesh from July 2021 to June 2022. A total of 196 patients were enrolled in this study as per selection criteria. All relevant data were collected in a data collection form (questionnaire). Data were processed and analyzed with the help of computer program SPSS windows version 23.0. Conclusion will be set on the basis of findings. The maximum patients (46.4%) were in the age group of 25 to 29 years. Mean age of the study subjects was 26.13±3.63 years ranged from 20-35 years. Most of the patients were housewife (91.8%). Most of the cases parity was single (57.7%) followed by 2 in 22.4% cases and >2 in 19.9% cases. Most women were in their second pregnancy (63.3%), while 30.6% were in their third pregnancy. Complete expulsion was occurred in 86.7% cases, incomplete in 10.2% cases and no expulsion in 3.1% cases. Mean number of doses of misoprostol for successful expulsion was 4.12±0.90 ranged from 1 to 5 doses. Mean time interval between 1st dose and spontaneous expulsion 9.39±2.74 hours ranged from 3 to 12 hours. Complications following mid trimester termination of pregnancy were severe hemorrhage (28.1%), retained placenta (17.9%), severe pain (14.3%) and scar rupture (4.6%). No complication was observed in 55.5 cases. Mid-trimester medical termianl of pregnancy with mifepristone-misoprostol is a safe and effective procedure for the patients with previous caesarian section.