Complication of over-the-counter use of medical abortion pills including ectopic pregnancy: a prospective observational study from a tertiary care centre

Preeti Kanal; Anjali Soni; Smiriti Agnihotri; Rajni Gautam

doi:10.18203/2320-1770.ijrcog20263980

Authors

Preeti Kanal Department of Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Anjali Soni Department of Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Smiriti Agnihotri Department of Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Rajni Gautam Department of Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20263980

Keywords:

Medical abortion, OTC use, Incomplete abortion, Ectopic pregnancy, Anemia

Abstract

Background: Over-the-counter (OTC) availability of medical abortion pills has led to widespread unsupervised self-administration, increasing clinical complications and the risk of missed ectopic pregnancy.

Methods: A prospective observational study was conducted on 50 women presenting with a history of self-administered abortion pills between October 2025 and March 2026 at a tertiary care centre in northern India. Clinical presentations, diagnostic findings, and therapeutic management were systematically analyzed using IBM SPSS Statistics software.

Results: Bleeding per vaginum was the most common presentation (84%). Major complications included incomplete abortion (68%), severe anemia requiring blood transfusion, and ruptured ectopic pregnancy (8%). All ectopic pregnancies identified were ruptured at presentation and required emergency exploratory laparotomy, with intraoperative hemoperitoneum ranging from 400 to 800 ml.

Conclusions: OTC use of abortion pills is associated with significant morbidity, including life-threatening ruptured ectopic pregnancy. Proper medical evaluation prior to abortifacient use is indispensable. Stricter enforcement of drug distribution regulations and enhanced public awareness regarding safe abortion practices are urgently needed.

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