Duration of Induction of Labor for Second-Trimester Medication Abortion and Adverse Outcomes.
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
11 Jul 2024
11 Jul 2024
Historique:
received:
14
04
2024
accepted:
23
05
2024
medline:
11
7
2024
pubmed:
11
7
2024
entrez:
11
7
2024
Statut:
aheadofprint
Résumé
To evaluate the relationship between duration of labor during second-trimester medication abortion and adverse outcomes. We conducted a retrospective cohort study including all individuals with a singleton gestation undergoing second-trimester medication abortion without evidence of advanced cervical dilation, rupture of membranes, or preterm labor at four centers. The primary exposure was duration of labor (ie, hours spent from receiving misoprostol to fetal expulsion). The primary outcome was composite morbidity, defined as uterine rupture, need for blood transfusion, clinical chorioamnionitis, intensive care unit admission, or need for readmission. We performed bivariate and multivariate negative binomial analyses. A post hoc subgroup analysis was performed to assess for the risk of the primary outcome by gestational age. We performed tests of homogeneity based on history of uterine scarring and parity. Six hundred eighty-one individuals were included. The median duration of labor was 11 hours (interquartile range 8-17 hours). One hundred thirty-one (19.2%) experienced the primary outcome. When duration of labor was evaluated continuously, a longer duration of labor was associated with an increased frequency of morbidity (adjusted β=0.68, 95% CI, 0.32-1.04). When duration of labor was evaluated categorically, those experiencing the highest quartile of duration (ie, 17 hours or more) had a statistically higher risk for experiencing morbidity compared with individuals in all other quartiles (adjusted relative risk 1.99, 95% CI, 1.34-2.96). When we focused on components of the composite outcome, clinical chorioamnionitis was significantly different between those experiencing a longer duration and those experiencing a shorter duration of labor (26.2% vs 10.6%, P<.001). On subgroup analysis, gestational age was not associated with the risk of composite morbidity. Tests of homogeneity demonstrated no significant difference in the risk for morbidity among individuals with a history of uterine scarring or based on parity. Duration of labor was independently associated with risks for adverse maternal outcomes during second-trimester medication abortion, specifically clinical chorioamnionitis.
Identifiants
pubmed: 38991214
doi: 10.1097/AOG.0000000000005663
pii: 00006250-990000000-01107
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Financial Disclosure Ashish Premkumar is a scientific consultant for GenBioPro. Laura Laursen indicated that this article includes unlabeled/investigational uses of misoprostol for induction of labor. The other authors did not report any potential conflicts of interest.
Références
Kortsmit K, Nguyen AT, Mandel MG, Clark E, Hollier LM, Rodenhizer J, et al. Abortion surveillance—United States, 2020. MMWR Surveill Summ 2022;71:1–27. doi: 10.15585/mmwr.ss7110a1
doi: 10.15585/mmwr.ss7110a1
Gregory ECW, Valenzuela CP, Hoyert DL. Fetal mortality: United States, 2020. Natl Vital Stat Rep 2022;71:1–20. doi: 10.15620/cdc:118420
doi: 10.15620/cdc:118420
Centers for Disease Control and Prevention. WONDER online database, fetal death records 2005-2021. Accessed April 11, 2023. http://wonder.cdc.gov/fetal-deaths-current.html
Autry AM, Hayes EC, Jacobson GF, Kirby RS. A comparison of medical induction and dilation and evacuation for second-trimester abortion. Am J Obstet Gynecol 2002;187:393–7. doi: 10.1067/mob.2002.123887
doi: 10.1067/mob.2002.123887
Bryant AG, Grimes DA, Garrett JM, Stuart GS. Second-trimester abortion for fetal anomalies or fetal death: labor induction compared with dilation and evacuation. Obstet Gynecol 2011;117:788–92. doi: 10.1097/AOG.0b013e31820c3d26
doi: 10.1097/AOG.0b013e31820c3d26
Kelly T, Suddes J, Howel D, Hewison J, Robson S. Comparing medical versus surgical termination of pregnancy at 13-20 weeks of gestation: a randomised controlled trial. BJOG 2010;117:1512–20. doi: 10.1111/j.1471-0528.2010.02712.x
doi: 10.1111/j.1471-0528.2010.02712.x
Edlow AG, Hou MY, Maurer R, Benson C, Delli-Bovi L, Goldberg AB. Uterine evacuation for second-trimester fetal death and maternal morbidity. Obstet Gynecol 2011;117:307–16. doi: 10.1097/AOG.0b013e3182051519
doi: 10.1097/AOG.0b013e3182051519
Ryan I, Premkumar A, Watson K. Why the post-Roe era requires protecting conscientious provision as we protect conscientious refusal in health care. AMA J Ethics 2022;24:E906–12. doi: 10.1001/amajethics.2022.906
doi: 10.1001/amajethics.2022.906
Vinekar K, Karlapudi A, Nathan L, Turk JK, Rible R, Steinauer J. Projected implications of overturning roe v wade on abortion training in U.S. obstetrics and gynecology residency programs. Obstet Gynecol 2022;140:146–9. doi: 10.1097/AOG.0000000000004832
doi: 10.1097/AOG.0000000000004832
Grobman WA, Bailit J, Lai Y, Reddy UM, Wapner RJ, Varner MW, et al. Defining failed induction of labor. Am J Obstet Gynecol 2018;218:122.e1–8. doi: 10.1016/j.ajog.2017.11.556
doi: 10.1016/j.ajog.2017.11.556
Kawakita T, Reddy UM, Iqbal SN, Landy HJ, Huang CC, Hoffman M, et al. Duration of oxytocin and rupture of the membranes before diagnosing a failed induction of labor. Obstet Gynecol 2016;128:373–80. doi: 10.1097/aog.0000000000001527
doi: 10.1097/aog.0000000000001527
Rouse DJ, Weiner SJ, Bloom SL, Varner MW, Spong CY, Ramin SM, et al. Failed labor induction: toward an objective diagnosis. Obstet Gynecol 2011;117:267–72. doi: 10.1097/AOG.0b013e318207887a
doi: 10.1097/AOG.0b013e318207887a
Hong J, Atkinson J, Roddy Mitchell A, Tong S, Walker SP, Middleton A, et al. Comparison of maternal labor-related complications and neonatal outcomes following elective induction of labor at 39 weeks of gestation vs expectant management: a systematic review and meta-analysis. JAMA Netw Open 2023;6:e2313162. doi: 10.1001/jamanetworkopen.2023.13162
doi: 10.1001/jamanetworkopen.2023.13162
Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med 2004;351:2581–9. doi: 10.1056/NEJMoa040405
doi: 10.1056/NEJMoa040405
Landon MB, Spong CY, Thom E, Hauth JC, Bloom SL, Varner MW, et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol 2006;108:12–20. doi: 10.1097/01.AOG.0000224694.32531.f3
doi: 10.1097/01.AOG.0000224694.32531.f3
Henkel A, Miller HE, Zhang J, Lyell DJ, Shaw KA. Prior cesarean birth and risk of uterine rupture in second-trimester medication abortions using mifepristone and misoprostol: a systematic review and meta-analysis. Obstet Gynecol 2023;142:1357–64. doi: 10.1097/aog.0000000000005259
doi: 10.1097/aog.0000000000005259
Second-trimester abortion. Practice Bulletin No. 135. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:1394–406. doi: 10.1097/01.AOG.0000431056.79334.cc
doi: 10.1097/01.AOG.0000431056.79334.cc
Borgatta L, Kapp N; Society of Family Planning. Clinical guidelines: labor induction abortion in the second trimester. Contraception 2011;84:4–18. doi: 10.1016/j.contraception.2011.02.005
doi: 10.1016/j.contraception.2011.02.005
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research Electronic Data Capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–81. doi: 10.1016/j.jbi.2008.08.010
doi: 10.1016/j.jbi.2008.08.010
Testani E, Latta K, Barker E, York SL, Laursen L. Complications of second-trimester medical termination of pregnancy for fetal anomalies compared with intrauterine fetal demise. Int J Gynaecol Obstet 2023;160:145–9. doi: 10.1002/ijgo.14302
doi: 10.1002/ijgo.14302
Latta K, Barker E, Kendall P, Testani E, Laursen L, McClosky L, et al. Complications of second trimester induction for abortion or fetal demise for patients with and without prior cesarean delivery. Contraception 2023;117:55–60. doi: 10.1016/j.contraception.2022.06.011
doi: 10.1016/j.contraception.2022.06.011
Joseph KS, Lisonkova S, Boutin A, Muraca GM, Razaz N, John S, et al. Maternal mortality in the United States: are the high and rising rates due to changes in obstetrical factors, maternal medical conditions, or maternal mortality surveillance? Am J Obstet Gynecol 2024;230:440.e1–13. doi: 10.1016/j.ajog.2023.12.038
doi: 10.1016/j.ajog.2023.12.038
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371:75–84. doi: 10.1016/s0140-6736(08)60074-4
doi: 10.1016/s0140-6736(08)60074-4
Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol 2010;37:339–54. doi: 10.1016/j.clp.2010.02.003
doi: 10.1016/j.clp.2010.02.003
Lee SE, Romero R, Park CW, Jun JK, Yoon BH. The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Am J Obstet Gynecol 2008;198:633.e1–8. doi: 10.1016/j.ajog.2007.11.047
doi: 10.1016/j.ajog.2007.11.047
Madar H, Goffinet F, Seco A, Rozenberg P, Dupont C, Deneux-Tharaux C, et al. Severe acute maternal morbidity in twin compared with singleton pregnancies. Obstet Gynecol 2019;133:1141–50. doi: 10.1097/aog.0000000000003261
doi: 10.1097/aog.0000000000003261
Leftwich HK, Zaki MN, Wilkins I, Hibbard JU. Labor patterns in twin gestations. Am J Obstet Gynecol 2013;209:254.e1–5. doi: 10.1016/j.ajog.2013.06.019
doi: 10.1016/j.ajog.2013.06.019
Altman DG, Royston P. The cost of dichotomising continuous variables. BMJ 2006;332:1080. doi: 10.1136/bmj.332.7549.1080
doi: 10.1136/bmj.332.7549.1080
Intrapartum management of intraamniotic infection.Committee Opinion No. 712. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;130:e95–101. doi: 10.1097/aog.0000000000002236
doi: 10.1097/aog.0000000000002236
Goldberg AB, Greenberg MB, Darney PD. Misoprostol and pregnancy. N Engl J Med 2001;344:38–47. doi: 10.1056/nejm200101043440107
doi: 10.1056/nejm200101043440107
Elati A, Weeks A. Risk of fever after misoprostol for the prevention of postpartum hemorrhage: a meta-analysis. Obstet Gynecol 2012;120:1140–8. doi: 10.1097/aog.0b013e3182707341
doi: 10.1097/aog.0b013e3182707341
Whitehouse KC, Stifani BM, Duffy JMN, Kim CR, Creinin MD, DePiñeres T, et al. Standardizing Abortion Research Outcomes (STAR): results from an international consensus development study. Contraception 2021;104:484–91. doi: 10.1016/j.contraception.2021.07.004
doi: 10.1016/j.contraception.2021.07.004
Babyak MA. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med 2004;66:411–21. doi: 10.1097/01.psy.0000127692.23278.a9
doi: 10.1097/01.psy.0000127692.23278.a9
Abbas DF, Blum J, Ngoc NTN, Nga NTB, Chi HTK, Martin R, et al. Simultaneous administration compared with a 24-hour mifepristone-misoprostol interval in second-trimester abortion: a randomized controlled trial. Obstet Gynecol 2016;128:1077–83. doi: 10.1097/AOG.0000000000001688
doi: 10.1097/AOG.0000000000001688
Shrier I, Platt RW. Reducing bias through directed acyclic graphs. BMC Med Res Methodol 2008;8:70. doi: 10.1186/1471-2288-8-70
doi: 10.1186/1471-2288-8-70
Ananth CV, Schisterman EF. Confounding, causality, and confusion: the role of intermediate variables in interpreting observational studies in obstetrics. Am J Obstet Gynecol 2017;217:167–75. doi: 10.1016/j.ajog.2017.04.016
doi: 10.1016/j.ajog.2017.04.016
Ananth CV, Brandt JS. A principled approach to mediation analysis in perinatal epidemiology. Am J Obstet Gynecol 2022;226:24–32.e6. doi: 10.1016/j.ajog.2021.10.028
doi: 10.1016/j.ajog.2021.10.028
Borgatta L, Chen AY, Vragovic O, Stubblefield PG, Magloire CA. A randomized clinical trial of the addition of laminaria to misoprostol and hypertonic saline for second-trimester induction abortion. Contraception 2005;72:358–61. doi: 10.1016/j.contraception.2005.04.016
doi: 10.1016/j.contraception.2005.04.016
Premkumar A, Manthena V, Vuppaladhadiam L, van Etten K, McLaren H, Grobman WA. The use of adjunctive mechanical dilation at the time of induction termination and adverse health outcomes: a systematic review. Am J Obstet Gynecol MFM 2024;6:101263. doi: 10.1016/j.ajogmf.2023.101263
doi: 10.1016/j.ajogmf.2023.101263
Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 2007;4:e297. doi: 10.1371/journal.pmed.0040297
doi: 10.1371/journal.pmed.0040297
Postpartum hemorrhage.Practice Bulletin No. 183. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;130:e168–86. doi: 10.1097/aog.0000000000002351
doi: 10.1097/aog.0000000000002351
Masse NM, Kuchta K, Plunkett BA, Ouyang DW. Complications associated with second trimester inductions of labor requiring greater than five doses of misoprostol. Contraception 2020;101:53–5. doi: 10.1016/j.contraception.2019.09.004
doi: 10.1016/j.contraception.2019.09.004
Sharma C, Dadhwal A, Soni A. A randomized controlled trial comparing combined medical and mechanical method for early mid-trimester abortion (13-20 weeks). Int J Gynaecol Obstet 2023;161:624–30. doi: 10.1002/ijgo.14616
doi: 10.1002/ijgo.14616
Elasy AN, Ibrahem MA, Elhawy LL, Hamed BM. Vaginal misoprostol versus combined intracervical Foley's catheter and oxytocin infusion for second trimester pregnancy termination in women with previous caesarean sections: a randomised control trial. J Obstet Gynaecol 2022;42:2962–9. doi: 10.1080/01443615.2022.2118572
doi: 10.1080/01443615.2022.2118572
Anselem O, Jouannic JM, Winer N, Bouchghoul H, Vivanti AJ, Quibel T, et al. Cervical dilators used concurrently with misoprostol to shorten labor in second-trimester termination of pregnancy: a randomized controlled trial. Obstet Gynecol 2022;140:453–60. doi: 10.1097/AOG.0000000000004887
doi: 10.1097/AOG.0000000000004887
Barinov SV, Tirskaya YI, Shamina IV, Medyannikova IV, Kadcyna TV, Shkabarnya LL, et al. The use of an osmotic dilator for induction of miscarriage in patients with the second trimester missed miscarriage. J Matern Fetal Neonatal Med 2021;34:2778–82. doi: 10.1080/14767058.2019.1671331
doi: 10.1080/14767058.2019.1671331
El Sharkwy IAE, Elsayed ML, Ahmed MA, Alnemer AAA. Low-dose vaginal misoprostol with or without Foley catheter for late second-trimester pregnancy termination in women with previous multiple cesarean sections. J Matern Fetal Neonatal Med 2019;32:3703–7. doi: 10.1080/14767058.2018.1470236
doi: 10.1080/14767058.2018.1470236
Wang YX, Zeng R, Huang MJ, Zhu WJ, Tu M. Comparison of preliminary clinical efficacy for two cervical preparations for early second-trimester pregnancy termination at 12-17 weeks gestation. J Reprod Contraception 2011;22:83–8. doi: 10.1016/S1001-7844(11)60009-6
doi: 10.1016/S1001-7844(11)60009-6
Jansen NE, Pasker-De Jong PC, Zondervan HA. Mifepristone and misoprostol versus Dilapan and sulprostone for second trimester termination of pregnancy. J Matern Fetal Neonatal Med 2008;21:847–51. doi: 10.1080/14767050802283027
doi: 10.1080/14767050802283027
Prairie BA, Lauria MR, Kapp N, Mackenzie T, Baker ER, George KE. Mifepristone versus laminaria: a randomized controlled trial of cervical ripening in midtrimester termination. Contraception 2007;76:383–8. doi: 10.1016/j.contraception.2007.07.008
doi: 10.1016/j.contraception.2007.07.008
Bani-Irshaid I, Athamneh TZ, Bani-Khaled D, Al-Momani M, Dahamsheh H. Termination of second and early third trimester pregnancy: comparison of 3 methods. East Mediterr Health J 2006;12:605–9.
Almog B, Levin I, Winkler N, Fainaru O, Pauzner D, Lessing JB, et al. The contribution of laminaria placement for cervical ripening in second trimester termination of pregnancy induced by intra-amniotic injection of prostaglandin F(2)alpha followed by concentrated oxytocin infusion. Eur J Obstet Gynecol Reprod Biol 2005;118:32–5. doi: 10.1016/j.ejogrb.2004.04.003
doi: 10.1016/j.ejogrb.2004.04.003
Nasioudis D, Kim SW, Schoen C, Levine LD. Maternal and neonatal outcomes with mechanical cervical dilation plus misoprostol compared to misoprostol alone for cervical ripening; a systematic review of literature and metaanalysis. Am J Obstet Gynecol MFM 2019;1:101–11. doi: 10.1016/j.ajogmf.2019.06.003
doi: 10.1016/j.ajogmf.2019.06.003
Yin J, Li Y, Chen Y, Wang C, Song X. Intracervical Foley catheter plus intravaginal misoprostol compared to intravaginal misoprostol-only for cervical ripening: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023;281:76–84. doi: 10.1016/j.ejogrb.2022.12.022
doi: 10.1016/j.ejogrb.2022.12.022
Lee HH, Huang BS, Cheng M, Yeh CC, Lin IC, Horng HC, et al. Intracervical foley catheter plus intravaginal misoprostol vs intravaginal misoprostol alone for cervical ripening: a meta-analysis. Int J Environ Res Public Health 2020;17:1825. doi: 10.3390/ijerph17061825
doi: 10.3390/ijerph17061825
Orr L, Reisinger-Kindle K, Roy A, Levine L, Connolly K, Visintainer P, et al. Combination of Foley and prostaglandins versus Foley and oxytocin for cervical ripening: a network meta-analysis. Am J Obstet Gynecol 2020;223:743.e1–17. doi: 10.1016/j.ajog.2020.05.007
doi: 10.1016/j.ajog.2020.05.007
Allanson ER, Copson S, Spilsbury K, Criddle S, Jennings B, Doherty DA, et al. Pretreatment with mifepristone compared with misoprostol alone for delivery after fetal death between 14 and 28 weeks of gestation: a randomized controlled trial. Obstet Gynecol 2021;137:801–9. doi: 10.1097/aog.0000000000004344
doi: 10.1097/aog.0000000000004344
Zwerling B, Edelman A, Jackson A, Burke A, Prabhu M. Society of family planning clinical recommendation: medication abortion between 14 0/7 and 27 6/7 weeks of gestation. Contraception 2024;129:110143. doi: 10.1016/j.contraception.2023.110143
doi: 10.1016/j.contraception.2023.110143