DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205218

Incomplete abortion following medical method of abortion: study at a tertiary care teaching hospital at Bihar

Pushpa .

Abstract


Background: Medical method of abortion (MMA) is a safe and effective method of abortion. Combination of mifepristone and misoprostol is most widely used. However, this is being randomly used by women without proper prescription which can lead to life threatening complications.

Methods: This is an observational study done at Patna Medical College and Hospital, Patna, a tertiary care teaching hospital in Bihar, in a period of one year from March 2019 to February 2020. This is an attempt to study incomplete abortion after medical method of abortion and to observe the method of taking it among patients, with prescriptions or without it. Hundred women with incomplete abortion following MMA in 1st trimester of pregnancy were included. Patients’ age, parity, gestational age, locality, complaints, complications and treatment were noted. An information regarding method of administration and prescription noted.

Results: 96% women used combined mifepristone plus misoprostol drug. Only 12% took the medicine on prescription of MBBS doctor, rest were all either self-administered or advised by quacks. Blood transfusion was required in 60% patients.

Conclusions: Medical method of abortion is safe and effective but complications can occur if not used in accordance with guidelines. Women should be taught about and motivated for contraception. Adequate training to health care providers about comprehensive abortion care should be given.


Keywords


MMA, MTP, Incomplete abortion, Sepsis

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References


World Health Organisation. Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. 6th edition Geneva: World Health Organisation. 2011. Accessed on 10 October, 2020.

Handbook on Medical Methods of Abortion; to Expand Access to New Technologies for Safe Abortion. Ministry of Health & Family Welfare, Government of India. 2016.

Abortion and Unintended Pregnancy in Six Indian States: Findings and Implications for Policies and Programs. Guttmacher Institute 2018 Report. 2018. https://www.guttmacher.org/report/abortion-unintended-pregnancy-six-states-india#. Accessed on 10 October, 2020.

Pawde AA, Ambadkar A, Chauhan AR: A Study of Incomplete Abortion Following Medical Method of Abortion. J Obstet Gynaecol India. 2016;66(4):239-43.

Thoai DN, Park MH, Shakur H. Home-based versus clinic-based medical abortion: systematic review. Bull World Health Organ. 2011;89:360-70.

Coyaji K. Early medical abortion in India: three studies and their implications for abortion services. J Am Med Womens Assoc. 2000;55(3):191-4.

Kopp Kallner H, Fiala C, Stephansson O. Home self-administration of vaginal misoprostol for medical abortion at 50-63 days. Hum Reprod. 2010;25:1153-7.

Henderson JT, Hwang AC, Harper CC. Safety of mifepristone abortion in clinical use. Contraception. 2005;72:175-8.

Bhutta SZ, Aziz S, Korejo R. Surgical complications following unsafe abortion. JPMA. 2003;53:286-90.

The Medical Termination of Pregnancy (Amendment) Bill, 2020. 2020 https://www.prsindia.org/billtrack/medical-termination-pregnancy-amendment-bill-2020. Accessed on 10 October, 2020.

The medical termination of pregnancy amendment act, 2002. No. 64 of 2002. 2002. Accessed on 10 October, 2020.