Mifepristone-misoprostol combination in medical termination of early pregnancy

Devdatt Laxman Pitale


Background: Unplanned and unwanted pregnancies are common worldwide despite of the medical advancements and wider availability of contraceptive methods. The development of safe, effective, inexpensive, nonsurgical methods of abortion is thus highly desirable. Objective of present study was to evaluate the effectiveness of Mifepristone 200 mg orally followed by Misoprostol 800 µg intravaginally 48 hours later in women undergoing medical termination of early pregnancy (up to 63 days of gestational age).

Methods: The present study included 100 pregnant women requesting termination of pregnancy in first trimester attending the department of Obstetrics and Gynecology. Women with gestational age up to 63 days from the first day of the last menstrual period with previous regular cycles were studied. Patients without medical or surgical contraindications to Mifepristone and Misoprostol were included.

Results: Majority of the pregnant women belonged to the age group between 20-30 years. 30% of these women were nulliparous and 70 % were multiparous. The period of gestation varied from 35-63 days.90% of the patients had complete abortion and 10% had incomplete abortion. All the patients expelled the products of conception within 24 hours of prostaglandin administration. The adverse effects reported were nausea reported by 30%, vomiting by 5 %and diarrhea by 2% of the cases. None of the patients reported excess bleeding at the time of abortion, hospitalization or blood transfusion. This regimen has the effectiveness of complete abortion rate with few side effects.

Conclusions: The Mifepristone- Misoprostol combination offers an effective, acceptable, out-patient procedure and an alternative to surgical methods of abortion in medical termination of early pregnancy (up to 63 days of gestation).


Abortion, Mifepristone, Misoprostol

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Nivedita K, Shanthi F. Is it safe to provide abortion pills over the counter? A study on outcome following self-medication with abortion pills. JCDR. 2015 Jan;9(1):QC01.

MOHFW. Ensuring access to safe abortion and addressing gender biased sex selection. 2015. Available at

Vani PY, Devi AN. Efficacy of Mifepristone and Misoprostol combination in termination of early pregnancy. IAIM. 2016;3(12):48-54.

FOGSI focus on Medical abortion. FOGSI-ICOG-GCPR guidelines (2011). Available at abortion 2011.

Faundes A, Fiala C, Tang, Velasco A(2007). Misoprostol for the termination of pregnancy up to 12 completed weeks of pregnancy. Int J Gynecol Obstet. 2007;99:S172-S177.

Sahu RR, Soni AA, Raut VS. Randomised control study on oral vs vaginal and sublingual misoprostol with mifepristone for first -trimester MTP. Indian J Clin Pract. 2013;24(7).

Von Hertzen H, Huong NT, Piaggio G, Bayalag M, Cabezas E, Fang AH et al. Misoprostol dose and route after mifepristone for early medical abortion: a randomised controlled noninferiority trial. BJOG. 2010 Sep 1;117(10):1186-96.

Veena S. Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women. N J Obstet Gynecol. 2007;2(2):54-8.

Crenin M, Grossman D. Committee on Practice Bulletins-Gynecology and the Society of Family Planning. 2014;143. Available at

FOGSI ICOG Good Clinical Practice Recommendation. J Obstet Gynecol India. 2011:90-2. Available at