الفهرس 
MiscarriageOnly 14 pages are availabe for public view
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Abstract
Background: Abortion-related morbidity and mortality rises considerably as gestation progresses. Second trimesteric abortions constitute 10-15% of all abortions; however, they account for 75% of all complications and 50% of abortion related deaths. Aim of the Work: to find correlation between pre-induction cervical length measured trans-vaginally and successful induction of second tri-mesteric abortion. Patients and Methods: A prospective observational study was carried out at Ain-Shams University Maternity Hospital in the period between November 2019 and November 2020. The participants of this study were 221 prim gravid or multipara pregnant women (14-26 weeks) aged 18-40 years old with fetal demise of singleton pregnancy and non-scarred uterus attending the labor ward for elective second trimester pregnancy termination using misoprostol. Trans-vaginal ultrasonography of the cervix was done for all participants prior to induction of abortion on the same day. Cervical length was measured in a sagittal plane. A straight line between the internal os and external os including the cervical canal was measured. Results: about three quarters of cases (74.7%) completed abortion ≤ 24.0 hours and the remaining quarter (56/221) (25.3%) completed abortion > 24.0 hours and nausea was the most common side effect of misoprostol. Age and cervical length were significantly lower (32.0±4.6 vs. 29.5±4.7 years and 32.9±2.2 vs. 36.4±2.1 mm) (P= <0.001), primi-gravida, nausea, diarrhea, fever and shivering were significantly less frequent (19 vs. 27, 17 vs. 14, 4 vs. 8, 2 vs. 7 and 0 vs. 4) (P= <0.001, 0.006, 0.002, <0.001 and 0.004) and history of abortion was significantly higher (52 vs.8) (P= 0.012) respectively among cases with abortion within 24.0 hours. However, there was no significant difference between groups regarding BMI and gestational age (28.7±1.6 vs. 29.1±1.6 kg/m2, 20.6±2.7s. 21.4±2.0 wks.) (P= 0.133 and 0.143) respectively. Primigravida and multigravida at cut off point (≤35.0, ≤36.0 and ≤35.0 mm) respectively and the performance was higher in multiparous than in primiparous; (sensitivity 90.9%,78.9% and 92.5%, specificity 73.2%,77.8% and 58.6%, positive predictive value 90.9%, 71.4% and 91.8%, negative predictive value 73.2%, 84.0% and 60.7%). Conclusions: About 75 % of cases completed abortion ≤ 24.0 hours. Cervical length had moderate diagnostic performance in the predicting induction time within 24.0 hours in all case, primigravida and multigravida at cut off point (≤35.0, ≤36.0 and ≤35.0 mm) respectively and the performance was higher in multiparous in comparison to primiparous. Age and cervical length were significantly lower, primigravida, nausea, diarrhea, fever and shivering were significantly less frequent and history of abortion was significantly higher respectively amongst cases with abortion within 24.0 hours, however, there were no significant differences between groups regarding BMI and gestational age.