Misoprostol versus combined regimen of mifepristone and misoprostol in termination of second trimester pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251421Keywords:
Second trimester termination of pregnancy, Mifepristone, Misoprostol, Surgical intervention D and E, Induction abortion intervalAbstract
The present prospective study was conducted over 12 months at Dr. Mansukh Bhai K. Shah medical college and Sushilaben M. Shah multi-specialty hospital, Ahmedabad, serving predominantly lower socioeconomic groups. The objective was to assess the safety and efficacy of misoprostol alone versus a combined regimen of mifepristone and misoprostol in second-trimester pregnancy termination. A total of 18 patients were enrolled and divided into two groups. Group A received 200 mg oral mifepristone, followed 24 hours later by 200 mcg misoprostol administered vaginally every 4 hours up to a maximum of 4 doses or until expulsion occurred. Group B received only 200 mcg vaginal misoprostol every 4 hours, up to 4 doses. Success was defined as complete expulsion of the fetus and placenta without the need for surgical intervention. In group A, the success rate was 100%, and none of the patient’s required dilatation and evacuation (D and E). In contrast, group B had a success rate of 80%, with 2 patients (20%) requiring D and E. There were no failures in either group, defined as failure to abort within 72 hours of the last dose. The induction-abortion interval was shorter in the mifepristone-primed group. The study concludes that pre-treatment with mifepristone significantly improves the efficacy of second-trimester pregnancy termination with misoprostol, reduces the need for Surgical intervention, and shortens the induction-to-abortion interval. The combined regimen of mifepristone and misoprostol is thus more effective and safer than misoprostol alone.
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