Efficacy of single dose of misoprostol 800μg in the first trimester termination of pregnancy: a cross sectional study
Keywords:Abortion, Misoprostol, Termination
Background: The MTP (Amendment) Act 2021 has allowed termination of pregnancy up to 24 weeks on only certain indications. Decision of two medical practitioners are required for termination beyond 20 weeks. Misoprostol is one drug used for medical termination of pregnancy. It can be used alone in single or multiple doses, or in combination with other drugs. The study was undertaken to determine the efficacy of a single dose of 800 μg of misoprostol in the first trimester pregnancy termination.
Methods: It was a cross-sectional study conducted among 124 women in the first trimester who were undergoing termination of pregnancy. After administering 800 μg of misoprostol vaginally, participants were kept under observation for 48 hours. Data were collected and analysed.
Results: Around half of the participants (56.4%) expelled the conceptus completely by 12 hours, 78.2% by 48 hours. Seven (5.6%) out of those 27 failed cases were given further doses of misoprostol, while in the remaining 20 (16.1%), surgical intervention was undertaken.
Conclusions: The efficacy of a single dose of misoprostol for 1st trimester termination of pregnancy varies widely from study to study, but, the efficacy increases with adding further doses of the same drug or addition of mifepristone. Misoprostol is a safe, cost effective, and reasonable drug for the termination of pregnancy in first trimester.
Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Global Heal. 2020;8(9):e1152-61.
WHO. Unsafe abortion: global and regional estimates of incidence of unsafe abortion and associated mortality in 2000, 4th edition, 2004. Available at: www.who.int/reproductivehealth/publications/unsafe_abortion/924191803/e/. Accessed 15 November 2020.
The Medical Termination of Pregnancy (Amendment) Act, 2021. Ministry of Law and Justice (Legislative Department), 2021. Available at: https://prsindia.org/files/bills_acts/acts_parliament/2021/Medical%20Termination%20of%20Pregnancy%20Amendment%20Act%202021.pdf. Accessed on 15th August 2023.
World Health Organization. Medical management of abortion, 2018. Available at: https://iris.who.int/bitstream/handle/10665/278968/9789241550406-eng.pdf?ua=1. Accessed 15 November 2020.
Narasimaiah G, Pukale R, Shivanna BS, Sharma N. Effcacy of single dose of vaginal misoprostol 800ug in first trimester abortion. J Evol Med and Dental Sci. 2013;2(16):2669-74.
Salkos N , Kountouris A , Botsis D, Rizos D, Gregoriou O, G Detsis G, et al. First trimester pregnancy termination with 800ug of vaginal misoprostol every 12 hr. Eur J Contracept Reproduction Health Care. 2005;10(4):249-54.
Bugalho A, Mocumbi S, Fau A, David E. Termination of pregnancies of <6 weeks Gestation with a single dose of 800ug of vaginal misoprostol. Contraception. 2000;61(1):47-50.
Shanti S. Efficacy of single dose of 800ug of misoprostol in first trimester abortion. J Nobel Medi Coll. 2012;1(2):729-28.
Costa SH. Commercial availability of misoprostol and induced abortion in Brazil. Inter J Gynecol Obstet. 1998;63:S131-9.
Kobryn E, SzymusikI, Zgliczynska M, Szarla K, Kopylowska N, Piatek S, et al. The efficacy of misoprostol in the first trimester miscarriage treatment .an individual patients’ data analysis. Neuro Endocrinol Lett. 2019;40(3):152-8.