Erdin İLTER, Aygen ÇELİK, Tonguç GÜNDÜZ, Berna HALİLOĞLU, Meryem KÜÇÜKAŞÇI, Moşe BENHABİB, Serpil BOZKURT, Ümit ÖZEKİCİ

10 Haftalıktan Önceki İstemli Gebelik Sonlandırılmasında Kullanılan Manuel Vakum Aspirasyonundan Önce 400 μg Oral ve Vaginal Misoprostolün Karşılaştırılması

Amaç: Bu çalışmanın amacı 10 haftadan küçük gebeliklerin terminasyonu için kullanılan cerrahi evakuasyonun 3 ve 6 saat öncesi kullanılan 400 μg oral ve vaginal misoprostolün etkinliği ve tolerabilitesinin karşılaştırılması Gereç ve Yöntemler: Kliniğimizde en sık kullanılan 4 misoprostol rejiminin kullanıldığı 210 hasta retrospektif olarak değerlendirildi; Evakuasyondan 3 saat önce oral 400 μg O3 , 6 saat önce oral 400 μg O6 , 3 saat önce ovaginal 400 μg V3 , 6 saat önce vaginal 400 μg V6 . Bulgular: Dozajına, kullanım yoluna ve zamanlamasına bakılmaksızın misoprostolün servikal dilatasyon üzerine belirgin etkisi vardır. Dilatasyon ihtiyacı kontrol grubuna kıyasla tüm misoprostol gruplarında belirgin olarak azdır. Diğer dört gruba kıyasla kontrol grubunda %5.8 oranla aşırı miktarda kan kaybı izlenmiştir. Postoperatif inceleme, hematocrit düşüşü, endometrial kalınlık ve analjezik ihtiyacı tüm gruplarda benzer bulunmuştur. Preoperatif VAS skorları O6 ve V6 gruplarında yüksekti. En sık görünen yan etki bulantı olup, özellikle oral O3, O6 gruplarda belirgindi. Sonuç: Analiz 10 haftalık ve öncesi gebeliğin istemli sonlandırılmasından 3 saat önce alınan 400 μg vaginal misoprostolün ideal kullanım yolu ve dozajı olarak göstermektedir.

Anahtar Kelimeler:

Misoprostol, planlanmamış gebelik

400 μg Oral and Vaginal Misoprostol Comparison Before Manual Vacuum Aspiration for Voluntary Termination of Pregnancy Before 10 Weeks Gestation

Aim: The aim of the present study was to compare the effectiveness and tolerability of 400 μg oral and 400 μg vaginal misoprostol administered 3 or 6 hours before surgical evacuation for termination of pregnancy before 10 weeks of gestation Material and Method: A total of 210 patients with mostly used four regimens in our department; oral 400 μg misoprostol 3 hours before evacuation O3 , oral 400 μg misoprostol 6 hours before evacuation O6 , vaginal 400 μg misoprostol 3 hours before evacuation V3 , vaginal 400 μg misoprostol 6 hours before evacuation V6 were retrospectively analyzed. Results: Misoprostol administration regardless to dosage, route and timing had significant effect on cervical dilatation. Dilatation requirement was significantly low in all misoprostol groups compared with control. 5.8% of subjects in control group had abundant blood loss significantly higher than other four groups. Postoperative evaluation showed that hematocrite decrease, endometrial thickness measurement and postoperative analgesic usage were similar in all groups. Preoperative VAS scores were higher in O6 and V6 groups. The most frequent side effect was nausea and it was especialy seen in oral O3,O6 groups. Conclusion: The analyze showed that 400 μg vaginal misoprostol taken 3 hours before vacuum aspiration for voluntary termination of pregnancy before 10weeks gestation seems as an ideal route and dosage.

Keywords:

Misoprostol, unplanned pregnancy,

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