Evaluation of mid trimester abortion (13-20 weeks) using newer regimen of mifepristone with misoprostol versus misoprostol alone

Authors

  • Vinita Singh Department of Obstetrics and Gynaecology, Tata Main Hospital, Jamshedpur, Jharkhand, India
  • Ritika Sethia Department of Obstetrics and Gynaecology, Tata Main Hospital, Jamshedpur, Jharkhand, India
  • Sunita Murmu Department of Obstetrics and Gynaecology, Tata Main Hospital, Jamshedpur, Jharkhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163440

Keywords:

Second trimester abortion, Mifepristone, Misoprostol

Abstract

Background: Termination of pregnancy in second trimester continues to be a challenge in developing countries especially in rural areas. There is an exponential rise in complications of abortion along with advancing gestational age. The search is on for an ideal method of abortion which is reliable, safe and cheap. This study was conducted in Tata main hospital, Jamshedpur from 15th November 2012 to 14th November 2014, with the aim of finding an effective method to induce second trimester abortion within reasonable time with fewer complications.

Methods: A total of 80 patients were studied to compare combination of mifepristone and misoprostol, with single drug misoprostol alone for second trimester abortion. The induction abortion interval (IAI), success rate and side effects were compared between the two groups.   .

Results: There was a significant difference in the IAI in both the groups. The mean IAI was 196.28 minutes in study group whereas in control group IAI was 318.92 minutes. The success rate (complete abortion) was 97.5% in study group and 92.5% in control group, but this was not statistically significant. More side effects were observed in the control group.

Conclusions: Mifepristone followed by misoprostol was more effective than misoprostol alone as it had a shorter IAI and fewer side effects.

 

References

Drey EA, Foster DG, Jackson. Risk factors associated with presenting for abortion in the second trimester. Obst Gyne. 2006;107(1):128-35.

Grimes DA. The continuing need for late abortions. JAMA. 1998; 280(8):747-50.

Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH. Induced abortion: estimated rates and trends worldwide. Lancet. 2007;370:1338-45.

Medical method for termination of pregnancy. WHO Technical Report Series 871. World Health Organisation, Geneva. 1997.

Urquhart DR, Templeton AA, Mifepristone (RU 486) and second-trimester termination. Lancet. 1987;2(8572):1405.

Silvestre L, Dubios C, Renault M. Voluntary interruption of pregnancy with mifepristone (RU 486) and a prostaglandin analogue. a large-scale French experience. New England J Med. 1990;322(10):645-8.

Gottlieb C, Bygdeman M. The use of antiprogestin (RU486) for termination of second trimester pregnancy. Acta Obstetrica Gynecologica Scandinavica. 1991;70(3):199-203.

Bygdeman M,Swahn ML. Progesterone receptor blockage. Effect on uterine contractility and early pregnancy. Contraception 1985; 32(1): 45-51.

Royal College of Obstetricians and Gynaecologists. Induced Abortion Guidelines No 11. London. 1997.

Mendileioglu M, Simsek PE, Seker O, Erbay CG, Zorlu B. Misoprostol in second and early third trimester for termination of pregnancies with fetal anomalies. Int J Gynae Obst. 2002;79:131-5.

Bartley J. A randomized study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the 2nd trimester of pregnancy. BJOG. 2002;109:1290-4.

Goh SE, Thong KJ. Induction of second trimester abortion (12-20 weeks) with mifepristone and misoprostol: a review of 386 consecutive cases. Contraception. 2006;73:516-9.

Premila WA, Templeton A. Nonsurgical mid-trimester termination of pregnancy: a review of 500 consecutive cases. Br J Obstet Gynaecol. 1999;106: 706-10.

Carbonella JL, Gallegob FG, Llorentea MP. Vaginal vs. sublingual misoprostol with for cervical priming in second trimester abortion by dilation and evacuation: a randomized trial. Contraception 2007;75:230-37.

Webster D. A comparison of 600 and 200 mg mifepristone prior to 2nd trimester abortion with the prostaglandin misoprostol. Br J Obstet Gynaecol. 1996;103(7):706-70.

Wong KS, Ngai CSW, Wong AYK, Tang LCH. Vaginal misoprostol compared with vaginal gemeprost in termination of second trimester pregnancy: a randomized trial. Contraception. 1998;58:207-10.

Patel U, Chauhan K, Singhi S, Kanani M. Second trimester abortion- mifepristone and misoprostol or misoprostol alone. Int J Reprod Contracept Obstet Gynecol. 2013;2(3):315-9.

Kapp N, Borgatta L, Stubblefield P. Mifepristone in second trimester medical abortion: a randomized controlled trial. Obstet Gynecol. 2007;110:1304-10.

Downloads

Published

2016-12-15

Issue

Section

Original Research Articles