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  • Title: Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy.
    Author: Patel A, Talmont E, Morfesis J, Pelta M, Gatter M, Momtaz MR, Piotrowski H, Cullins V, Planned Parenthood Federation of America Buccal Misoprostol Waiver Group.
    Journal: Contraception; 2006 Apr; 73(4):420-30. PubMed ID: 16531179.
    Abstract:
    OBJECTIVE: The objective of this retrospective, descriptive study is to assess the adequacy and safety of buccal misoprostol with and without laminaria for cervical preparation prior to second-trimester abortion. METHODS: We analyzed Planned Parenthood Federation of America data from 2,218 elective dilation and evacuation (D&E) procedures conducted on women at 12 to 23 6/7 weeks of gestation from April 2002 to March 2003. Each woman received 400, 600 or 800 microg of buccal misoprostol with or without laminaria for preprocedural cervical preparation. RESULTS: Of the patients, 62% received 400 mug, 32% received 600 microg and 6% received 800 microg of buccal misoprostol; 42.8% had laminaria inserted for phased cervical preparation. The adequacy of cervical dilation was 88.7%. The D&E procedure was completed during a single surgical procedure for 99.8%. The overall adverse event rate was 19.39 per 1,000 women, with a rate of 4.51 per 1,000 women for serious adverse events. CONCLUSIONS: This descriptive study suggests that use of buccal misoprostol with or without laminaria is effective and safe. If buccal misoprostol eliminates or reduces the need for phased, multiday laminaria 1-3 days prior to the surgical procedure, then its use may offer service advantages such as reduced number of clinic visits and fewer pelvic examinations per woman.
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