DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170383

A prospective study of efficacy and safety of mifepristone and vaginal misoprostol in termination of pregnancy up to 63 days of gestation

Mahima Jain, Sonali Sharma

Abstract


Background: Illegal abortion is still one of the important causes of maternal mortality in India accounting for approximately 13%. Medical Management of abortion is a non-surgical termination which does not require special facilities like operation theatre, hospital stay and thereby reduces complications associated with the same.

Methods: It is a prospective study done in a Tertiary care Government Hospital over a span from Jan 2015 to April 2016. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. In first visit Tab. mifepristone 200 mg. orally was given and advised to take Tab. misoprostol 800 mcg. Vaginally after 48 hours at home. They were counselled for side effects and asked to report in case of excess bleeding, pain, fever or no bleed for 24 hours of misoprostol. After 7 days follow up was done to ensure completion of abortion. Any additional drugs required were noted. Contraceptive advice is also given during these visits.

Results: In our study 60 cases were taken. Majority of women are between 20-29 years of age which is peak reproductive age. 61.1% women are of second parity. The success rate of medical methods is 96.6%, two cases out of 60 underwent surgical evacuation and one was lost to follow up. Most common adverse effect noted is abdominal cramps. No patient required hospitalization. Additional Misoprostol was required in 4 cases. This method is highly acceptable 95% cases as it is non invasive and preferred to adopt the same in future if needed.

Conclusions: Patient participation, motivation, compliance, regular follow up visits, ability to record and report complications are the pillars on which the success of medical methods depends. Hence overall, it came out to be safe and effective method.

Keywords


First trimester medical methods for termination of pregnancy, Up to 63 days of gestation

Full Text:

PDF

References


Pathfinder International Handbook for primary care medical practitioners. 2003, pg. 4-91.

Das V, Jain S, Gupta HP. The Journal of Obst and Gynecology of India, Sept. 2005;55(5),454-6.

Padubiri VC, Daftary SN, Shaws Textbook of Gynecology 13th edition, New Delhi, Elsevier, 2004: pg. 241.

Unsafe abortion Global and regional estimates of incidence of unsafe abortion and associated mortality in 2008, Sixth Edition, Geneva, World Health Organization, 2008.

Cheng L. Surgical versus medical methods for second trimester abortion. The WHO Reproductive Health Library, World Health Organization. 2008.

Revised edition of Guidelines for early medical abortion in India using Mifepristone and Misoprostol, WHO-CCR in Human Reproduction, AIIMS in collaboration with Ministry of Health and Family Welfare, GOI and Indian Council of Medical Research, 2007.

Suku MG, Pratap K. Miscarriage, Essentials of Obstetrics by Arulkumaran, Edition 4. 2013.

Grossman D. Medical methods for first trimester abortion: RHL commentary revised; 3 sept. 2004. The WHO Reproductive Health Library, Geneva: World Health Organisation.

Kumar S, Patreka M, Deshpande H. A Prospective Trial using Mifepristone and vaginal Misoprostol in termination of pregnancies up to 63 days of gestation – The Journal of Obstetrics and Gynecology of India. 2014;63(6):370-2.