Misoprostol vs. Foley's Catheter/Oxytocin Compared for Second Trimester Pregnancy Termination in Previous C-Section Patients

Second trimester pregnancy termination is a critical procedure for various reasons, including missed abortion, serious fetal abnormalities (e.g., central nervous system or skeletal malformations), or elective termination. For women with a history of Caesarean sections, the choice of induction method is particularly important due to concerns about uterine rupture and other complications. Current standard-of-care approaches often involve prostaglandins or mechanical dilation, but a clear consensus on the optimal, safest, and most effective method for this specific population remains limited, highlighting a significant clinical gap.

This randomized controlled trial enrolled 158 patients with previous Caesarean sections requiring second trimester pregnancy termination. Participants were allocated into two groups: Group I (Misoprostol group), comprising 79 patients, received Vaginal Misoprostol. Group II (Combined group), also with 79 patients, received a combination of Intracervical Foley's Catheter insertion followed by Oxytocin Infusion. The primary endpoints for both groups were the safety and efficacy of the respective procedures, which were meticulously followed up and documented throughout the study duration.