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Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol

This study’s aim was to determine relevant factors that influence the time interval between first induction and fetal expulsion in late termination of pregnancy (TOP) and TOP after previous feticide for severe fetal malformation with a mifepristone–misoprostol regime. This retrospective study includ...

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Autores principales: Reischer, Theresa, Limbach, Iris, Catic, Anja, Niedermaier, Katrin, Falcone, Veronica, Yerlikaya-Schatten, Gülen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918131/
https://www.ncbi.nlm.nih.gov/pubmed/36769518
http://dx.doi.org/10.3390/jcm12030869
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author Reischer, Theresa
Limbach, Iris
Catic, Anja
Niedermaier, Katrin
Falcone, Veronica
Yerlikaya-Schatten, Gülen
author_facet Reischer, Theresa
Limbach, Iris
Catic, Anja
Niedermaier, Katrin
Falcone, Veronica
Yerlikaya-Schatten, Gülen
author_sort Reischer, Theresa
collection PubMed
description This study’s aim was to determine relevant factors that influence the time interval between first induction and fetal expulsion in late termination of pregnancy (TOP) and TOP after previous feticide for severe fetal malformation with a mifepristone–misoprostol regime. This retrospective study included 913 TOPs from a single tertiary care referral center. In 197 out of 913 TOPs, a previous feticide had been performed due to advanced gestational age (after 22 + 0 weeks of gestation). Induction was accomplished using 600 mg mifepristone followed by 400 μg misoprostol. The interval between first induction with misoprostol and fetal expulsion was examined. Univariate and multivariate logistic regression analysis were used to predict an induction interval of 12 h or less. The median gestational age at induction of labor was 18.9 weeks of pregnancy. In 487 (53.3%) cases women delivered within 12 h; in 344 (37.7%) cases the induction interval was between 12 h and 36 h. In 82 (9%) cases induction took longer than 36 h. Factors that were significantly associated with a delivery duration of <12 h were a lower gestational age at induction (OR 0.87; 95% CI 0.84–0.89; p < 0.001) and a history of at least one previous vaginal delivery (OR 1.57; 95% CI 1.20–2.05; p < 0.001). Factors that had no impact included previous cesarean section, performing feticide before induction and maternal age. Maternal BMI showed a non-significant trend.
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spelling pubmed-99181312023-02-11 Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol Reischer, Theresa Limbach, Iris Catic, Anja Niedermaier, Katrin Falcone, Veronica Yerlikaya-Schatten, Gülen J Clin Med Article This study’s aim was to determine relevant factors that influence the time interval between first induction and fetal expulsion in late termination of pregnancy (TOP) and TOP after previous feticide for severe fetal malformation with a mifepristone–misoprostol regime. This retrospective study included 913 TOPs from a single tertiary care referral center. In 197 out of 913 TOPs, a previous feticide had been performed due to advanced gestational age (after 22 + 0 weeks of gestation). Induction was accomplished using 600 mg mifepristone followed by 400 μg misoprostol. The interval between first induction with misoprostol and fetal expulsion was examined. Univariate and multivariate logistic regression analysis were used to predict an induction interval of 12 h or less. The median gestational age at induction of labor was 18.9 weeks of pregnancy. In 487 (53.3%) cases women delivered within 12 h; in 344 (37.7%) cases the induction interval was between 12 h and 36 h. In 82 (9%) cases induction took longer than 36 h. Factors that were significantly associated with a delivery duration of <12 h were a lower gestational age at induction (OR 0.87; 95% CI 0.84–0.89; p < 0.001) and a history of at least one previous vaginal delivery (OR 1.57; 95% CI 1.20–2.05; p < 0.001). Factors that had no impact included previous cesarean section, performing feticide before induction and maternal age. Maternal BMI showed a non-significant trend. MDPI 2023-01-21 /pmc/articles/PMC9918131/ /pubmed/36769518 http://dx.doi.org/10.3390/jcm12030869 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Reischer, Theresa
Limbach, Iris
Catic, Anja
Niedermaier, Katrin
Falcone, Veronica
Yerlikaya-Schatten, Gülen
Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title_full Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title_fullStr Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title_full_unstemmed Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title_short Factors Influencing the Duration of Termination of Pregnancy for Fetal Anomaly with Mifepristone in Combination with Misoprostol
title_sort factors influencing the duration of termination of pregnancy for fetal anomaly with mifepristone in combination with misoprostol
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918131/
https://www.ncbi.nlm.nih.gov/pubmed/36769518
http://dx.doi.org/10.3390/jcm12030869
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