An observational study to evaluate the clinical outcomes and complications among women presenting with unsupervised MTP pill intake at a tertiary healthcare centre in South Gujarat
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262540Keywords:
Unsupervised MTP, Medical abortion, Complications, Incomplete abortion, IndiaAbstract
Background: Unsupervised use of medical termination of pregnancy (MTP) pills is increasingly common in developing countries like India due to easy over-the-counter availability. Although safe under medical supervision, inappropriate use may lead to serious complications. Objectives of this study was to evaluate clinical outcomes and complications among women presenting with unsupervised MTP pill intake at a tertiary healthcare centre.
Methods: This prospective observational study included 200 women who came with a history of unsupervised MTP pill intake at our hospital for one year, from March 2025 to March 2026, after obtaining official approval from the Institutional Ethical Committee. Data regarding demographic profile, gestational age, source of pills, clinical presentation, outcomes, complications, and treatment modalities were collected and analysed. Statistical associations were evaluated using appropriate tests, with p < 0.05 considered significant.
Results: The majority of subjects were aged 21–25 years (38%), with a predominance of multigravida, rural (73%), and lower socioeconomic status (67%). Only 29% had prior ultrasound, while most obtained MTP pills from medical stores (60%). Half of the subjects (50%) consumed pills at 7–9 weeks, and most presented within 8–14 days (38%). The most common complaint was bleeding with passage of clots (48.5%). Incomplete abortion (63%) was the predominant outcome, followed by missed abortion (17%). Anaemia (55%) was the most common complication, with 17% requiring blood transfusion. Most subjects required intervention, with 62% undergoing dilatation and evacuation. Adverse outcomes were significantly associated with lack of prior ultrasound and higher gestational age.
Conclusions: Unsupervised use of MTP pills is a significant public health concern leading to preventable complications. Easy over-the-counter availability promotes misuse without proper medical evaluation. Therefore, strict regulation of MTP pill distribution and dispensing only through authorized centers under medical supervision is essential.
References
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. The Lancet Global Health. 2020;8(9):e1152-61.
World Health Organization. Medical management of abortion. World Health Organization; 2019. Available at: https://apps.who.int/iris/handle/10665/329284. Accessed on 3 May 2026.
Bhalla S, Goyal LD, Bhalla S, Kaur B. Self-administered medical abortion pills: evaluation of the clinical outcome and complications among women presenting with unsupervised pill intake to a tertiary care hospital in Malwa region of Punjab, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(4):1537 42.
Singh P, Dhurwey N, Patel J. Demography, clinical profile and outcomes of self-prescribed abortion pills among women, experience from a tertiary care teaching hospital in central India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023;12(10):2949-54.
Shalini S, Mehrotra A, Singh P. Unsupervised use of abortion pills and its impact on woman’s health. Int J Pharm Clin Res. 2024;16(6):2248-51.
Thakur N, Verma RS, Nagaria T. Self-administration of Abortion Pills and its Maternal Outcome in Tertiary Care Center. Journal of South Asian Federation of Obstetrics and Gynaecology. 2023;15(2):144-8.
World Health Organization. Abortion care guideline. Geneva: WHO; 2022. Available at: https://www.who.int/publications/i/item/9789240039483. Accessed on 3 May 2026.
Sehgal S, Sahu B, Gupta D, Mehta S, Dhakar JS. Clinical Study of First Trimester Abortions in a Tertiary Care Centre. Life Sci. 2025;11(2):7139-45.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education; 2022.
The Medical Termination of Pregnancy (Amendment) Act, 2021. Ministry of Law and Justice, Government of India. The Gazette of India. 2021. Available at: https://books.google.com/books?id=0fkvEQAAQBAJ. Accessed on 3 May 2026.
Nivedita K, Fatima S, Desai RM. Evaluation of unsupervised medical abortion and its complications. Journal of Obstetrics and Gynecology of India. 2015;65(3):174-9.
De Meyer F, Beernaert K, Van de Velde S, Sterckx S, Van Assche K. Obstetricians’ views on extending the 12-week abortion limit in Belgium: A qualitative study. PLoS One. 2025;20(6):e0325434.
Elshahawi NA, Mashaly AM, El-Zayadi AA. Suction Evacuation versus Surgical Evacuation in Management of First Trimesteric Abortion: Prospective Study. The Egyptian Journal of Hospital Medicine. 2025;98:556-62.
Park K. Park’s Textbook of Preventive and Social Medicine. 27th ed. Jabalpur: Banarsidas Bhanot Publishers; 2023.
Calvert C, Owolabi O, Yeung F, Pittrof R, Ganatra B, Tunçalp Ö, et al. The magnitude and severity of abortion-related morbidity in settings with limited access to abortion services: a systematic review and meta-regression. BMJ Global Health. 2018;3(3):e000692.
Pandey S, Sapre S, Shrivastava R, Vaishnav SB. Complications necessitating hospitalization after MTP pill use: A 1-year retrospective study at a Tertiary Care Teaching Institute in Gujarat. Journal of South Asian Federation of Obstetrics and Gynaecology. 2024;16(6):644-9.
Pamnani N, Shah S. Population study for awareness about medical termination of pregnancy pills in population in India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2025;14(6):1760-7.
Varadarajan R, BT V. The Impact of Self-Administered Abortion Pills: An Observational Study in a Tertiary Care Hospital. European Journal of Cardiovascular Medicine. 2025;15(5):1.
Downloads
Published
How to Cite
Issue
Section
