Halil KAYA, Özgür SÖĞÜT, Mehmet Tahir GÖKDEMİR, Mehmet Akif DOKUZOĞLU

Medikal Abortus İçin Oral ve Vaginal Misoprostol Kullanımı

Misioprostol, sentetik bir PGE1 analoğu olup NSAİ ilaçların kronik kullanımındaki gastrik yan etkilerini azaltmak amacıyla kullanılmaktadır. Aynı zamanda gebelikte servikal dilatasyon için bir preindüksiyon ajanı olarak da kullanılmaktadır. Ucuz ve kolay ulaşılabilir olan misoprostol yan etki olarak uterin kontraksiyonlara neden olabilir. Bu yüzden istenmeyen gebeliklerin sonlandırılmasında illegal olarak da kullanılmaktadır. Tekrarlayan dozlarda oral ya da vajinal 800 mikrogram (mcg) misoprostol alımı sonrasında %50 -90 oranında abortus meydana gelmektedir. Bu vaka sunumunda abortus amaçlı yüksek dozda misoprostol (PGE1-Cytotec®) alımı sonrası acil servise başvuran; ancak abortus oluşmayan bir olgu sunulmuştur.

Anahtar Kelimeler:

Abortus, Fetal Takip, Kontrasepsiyon, Misoprostol

Using Oral and Intravaginal Misoprostol For Medical Abortion

Misoprostol is a synthetic PGE1 derivate that is used to reduce gastric side effects of chronic NSAI drugs. It is also used as a pre-induction agent for cervical dilatation at delivery event. Misoprostol is cheap and easy receivable drug that causes uterine contractions as side effect. For this reason it is used to terminate unwanted pregnancies illegally. After repetitive oral or intravaginal usage of 800 microgram (mcg) misoprostol abortus happens at range of 50% 90%. This case report is about high dose misoprostol (PGE1-Cytotec®) intake and unsuccessful abortion

Keywords:

Abortion, Fetal Monitoring, Contraception, Misoprostol.,

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Ngai SW, Au Yeung KC, Lao T, Ho PC. Oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women sixth to twelveth week of ges- tation. Contraception 1995;51:347-50.
Gary Cunningham F, Norman F. Gant, Kenneth J. Leveno, Larry C. Gilstrap III, John C.Hayth, Katharine D. Wen- strom. İnduction and Augmentation of Labor; Williams Ob- stetrics 2001;469-481.
Adair CD, Weeks JW, Barrilleaux S, Edwards M, Burlison K, Lewis DF. Oral or vaginal misoprostol administration for induction of labor:A randomized, double-blind trial. Obstet Gynecol 1998;92:810.
Danielsson KG, Marions L, Rodriguez A, Spur BW, Wong PY, Bygdeman M. Comparison between oral and vaginal administration of misoprostol on uterine contractility. Ob- stet Gynecol 1999;93:275-80.
Sanchez-Ramos L, Kaunitz AM, Delke I. Labor induction with 25 microg versus 50 microg intravaginal misoprostol: a systematic review. Obstet Gynecol 2002;99:145-53.
El-Refaey H, Templeton A . Early induction of abortion by a combination of mifepristone and misoprostol administered by the vaginal route . Contraception 1994;49:111-4.
Carbonell JLL,Varela L, Valezco A,Tanda R. Vaginal mizo- prostol for abortion at10-13 weeks gestation. Eur J contrac Rep Health C 1999;4:35-40.
Özdemir A,Güralp H, Hızıroğlu S, Ertopçu K,Özdemir M, Haberal A. İkinci trimestır gebeliklerin sonlandırılmasında PGE–1 ve PGE–2 ‘nin karşılaştırılması. Jinekoloji Obstet- rik. 1999;9:169-74.
Shetty A, Danielian P, Templeton A. A comparison of oral and vaginal misoprostol tablets in induction of labour at term. BJOG 2001;108:238-43.
Wing DA, Rakall A, Jones MM, Goodwin TM, Paul RH. Misoprostol: An effective agent for cervical ripening and labor induction. Am J Obstet Gynecol. 1995;172:1811-6.
Fonseca W, Alencar AJC, Mota FSB, Coelho HLL. Miso- prostol and congenital malformations. Lancet 1991;338:56.
Creinin MD, Vittinghoff E, Keder L. Methotreksate and misoprostol for early abortion: a multicenter trial. I. Safety and efficacy. Contraception. 1996;53: 321-27.
Zieman M, Fong S.K, Benowitz N.L, Bankster D, Darney P.D. Absorbtion kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol 1997;90:88-92.
Costa SH, Vessey MP. Misoprostol and illegal abortion in Rio de Janeiro, Brazil. Lancet 1993: 15;1258-61.
El-Rafaey H, Rajasekar D, Abdalia M, Calder L, Templeton A. Induction of abortion with mifepristone and oral or vagi- nal misoprostol. N Eng J Med 1995;332:983-87.
Burnett MA, Corbett CA, Gertenstein RJ. A randomized trial of laminaria tents versus misoprostol for cervical rip- ening in first trimester surgical abortion. J Obstet Gynecol Can 2005;27:38-42.
Ozden S,Delikara MN,Avci A,Fıçıcıoğlu C, İntravajinal misoprostolvs.expectant management in premature rupture of membranes with low Bishop scores at taerm.Int J Gyne- col Obstet 2002;77:109-15.