RESULTS
Table 1 shows the characteristics of included cases in the study according to the medical history and cause of ToP. The number of cases included in the study between the specified years was 563. ToP was performed in 357 (63%) of these cases below 24th (≤23 6/7) gestational week. The termination week of the remaining 206 (37%) cases was between 24th and 34th gestational weeks. In the comparative analysis of the demographic data of the two groups, there was no statistical difference in the numbers of gravida, parity and abortion (p>0.05) (Table 1). The rate of prior cesarean section in cases below the 24th gestational week was significantly higher than the cases between 24-34 weeks of gestation (p=0.030) (Table 1). As described in the material method section, feticide procedure was performed in all cases (except 19 cases with in utero demise) above the 22th gestational week. A single ToP method was sufficient in 94% of all cases terminated before 24 weeks of gestation (termination with misoprostol), but this rate remained at 86% in cases between 24 and 34 weeks of gestation, and a statistically significant difference was found (p=0.002) (Table 1).
Comparison between all groups according to total misoprostol dose, administration and labor time are shown in the Table 2. In accordance with the protocol described in the material method section, the total misoprostol administration time was statistically significantly higher due to the decrease in misoprostol doses administered between 24 and 34 weeks of gestation (p=0.000) (Table 2). Below the 24th gestational week, both the delivery process and the lenght of hospital stay were found to be shorter in pregnancy terminations (p=0.000) (Table 2). There was no statistical difference between the two groups in terms of need for transfusion and admission to maternal intensive care unit (MICU) (p=0.149, p=0.535, respectively) (Table 2).
Comparative results of all groups according to the number of ToP procedure and complications are given in the Table 3. When we divide both groups (G1-G4) into two groups in terms of the presence of cesarean section within themselves; The rate of needing more than one ToP method was found to be statistically significantly higher in the cesarean section group with terminations below the 24th gestational week (0.007). However, in ToPs between 24-34 weeks of gestation, whether there was a prior cesarean section or not did not change the number of ToP methods needed. (Table 3). There was no difference in the complication rate between the groups according to the gestational week or the presence of a prior cesarean section (p>0.05) (Table 3).
Uterine rupture occurred in a total of 3 cases. The most important common feature of these cases was that all of them were below the 24th gestational week. Two cases had a history of previous C/S (one C/S history in one case and two C/S history in the other case). There was a previous cerclage operation history in one case in G1. One of the three cases had to be performed hysterectomy. Two cases required blood transfusion (Table 4).