A retrospective study on various methods used in second trimester MTP at KIMS hospital and research centre, Bangalore





Cervical ripening, MTP, Dilapan-S


Background: Despite the fact that majority of abortions are performed in the first trimester, 10-15% of abortions have taken place in the second trimester period globally because of delayed diagnosis of fetal anomalies and failure to recognize an undesired pregnancy in the first trimester. This study aims to describe the various methods used in inducing second trimester abortions and to analyse the efficacy and safety profile of these methods.

Methods: Retrospective observational study. This study analysed case records of 30 patients who underwent second trimester abortion between the gestations of 12 and 28 weeks. All case records of patients who underwent second trimester abortion between the gestation 12 and 28 weeks from 1st January 2021 to 1st August 2021 at the department of obstetrics and Gynaecology, KIMS hospital and Research Centre, Bangalore was analysed. Dilapan-s (hygroscopic mechanical dilator), Foley’s and mifepristone for cervical ripening followed by varying doses of misoprostol are the different methods studied in this study population.

Results: Most of the patients in study population belonged to the age group of 28-32 years. 60% patients underwent MTP between the gestational ages of 16-20weeks.The commonest indication for MTP was fetal anomaly.

Conclusions: Mifepristone group had short induction to abortion interval but was associated with higher rates of retained placenta bits. Foleys group had the longest induction to abortion interval but reported no complications.

Author Biographies

Sankalpa A. J., Department of OBG, KIMS, Bangalore, Karnataka, India

Department of OBG

Jayanthy T., Department of OBG, KIMS, Bangalore, Karnataka, India

Deaprtment of OBG


Shah I, Ahman E. “Unsafe abortion: global and regional incidence, trends, consequences, and challenges”. J Obstetrics Gynaecology. 2009;31(12):1149-58.

Drey EA, Foster DG, Jackson RA. Risk factors associated with presenting for abortion in the second trimester. Obstetrics Gynecology. 2006;107:128-35.

Grimes DA. The continuing need for late abortions. JAMA. 1998;280:747-50.

Muyuni M, Vwalika B, Ahmed Y. “The determinants and outcomes of second trimester abortion at the university teaching hospital”. Medical J Zambia. 2014;41:1.

World Health Organization, Trends in Maternal Mortality: 1990 to 2010, WHO, UNICEF, UNFPA and the World Bank Estimates, Geneva, Switzerland; 2012.

Sathar Z, Singh S, Rashida G, Shah Z, Niazi R. “Induced abortions and unintended pregnancies in Pakistan,”. Studies in Family Planning. 2014;45(4):471-91.

Abiodun OM, Balogun OR, Adeleke NA, Farinloye EO. “Complications of unsafe abortion in South West Nigeria: a review of 96 cases,”. African J Med Medical Sci. 2013;42(1):111-5.

Berer M. “Hospital admission for complications of unsafe abortion”. The Lancet. 2006;368(9550):1848-9.

Ashok PW, Templeton A, Wagaarachchi PT, Flett GM. Midtrimester Medical Termination of Pregnancy: A Review of 1002 Consecutive Cases. Contraception. 2004;69:51-8.

Wong KS, Ngai CS, Yeo EL, Tang LCH, Ho PC. A Comparison of Two Regimens of Intravaginal Misoprostol for Termination of Second Trimester Pregnancy: A Randomized Comparative Trial. Human Reproduction. 2000;15:709-12.

Dickinson JE, Evans SF. A Comparison of Oral Misoprostol with Vaginal Misoprostol Administration in Second-Trimester Pregnancy Termination for Fetal Abnormality. Obstetrics Gynecology. 2003;101:1294-9.

Nagaria T, Sirmor N. Misoprostol vs mifepristone and misoprostol in second trimester termination of pregnancy. J Obstet Gynecol India. 2011;61(6):659-62.

Karsidag A, Buyukbayrak EE, Kars B, Dansuk R, Unal O, Turan MC. Vaginal versus sublingual misoprostol for second‐trimester pregnancy termination and effect on Doppler measurements. Int J Gynecol Obstet. 2009;106(3):250-3.

Bhattacharjee N, Saha SP, Ghoshroy SC, Bhowmik S, Barui G. A randomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy between 13 to 20 weeks. Australian New Zealand J Obstet Gynecol. 2008;48(2):165-71.

Nasreen A, Akhtar S, Shaheen N. Comparison of Foley’s Catheter with extra amniotic prostaglandin F2 alpha in termination of second trimester pregnancy. J Postgraduate Med Institute (Peshawar-Pakistan). 2011;23(4).

Amjad T, Akhter S. Termination of pregnancy with foetal death in second trimester: Foley’s catheter versus extra amniotic Prostaglandin. J Coll Physicians Surg Pak. 1999;9:403-5.

Shabana A, Salah H, Kandil M, Soliman E, Morsi D. Termination of mid-trimester pregnancies: misoprostol versus concurrent weighted Foley catheter and misoprostol. F1000 Research. 2012;1.

Ranjan S, Sarojini A, Mohapatra I, Vivekanand A, Ranjan S. Comparison of intravaginal misoprostol alone and in combination with intracervical Foley’s catheter for termination of second trimester pregnancy-3 years study at a tertiary care hospital. Perspect Med Res. 2016;4:3-8.

Rezk MA, Sanad Z, Dawood R, Emarh M, Masood A. Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. J Maternal-Fetal Neonat Med. 2015;28(1):93-6.






Original Research Articles