DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20185430

Study of role of tablet misoprostol and extra amniotic normal saline in second trimester abortion

Zinkal P. Kothadiya, Bhavesh B. Airao, Bipin R. Shah

Abstract


Background: Second-trimester pregnancy termination comprises 10 to 15 percent of the approximately 42 million abortions performed annually worldwide.  Second-trimester procedures can be performed either with medication or by mechanical methods (Foleys catheter) or surgically by dilation and evacuation (D and E) or hysterotomy. The objective of the present study was to evaluate and compare the efficacy and safety of Tablet Misoprostol and extra amniotic infusion of normal saline with balloon catheter in second trimester abortion, to find out the maternal outcome, to compare the induction- to delivery interval between tablet misoprostol and extra amniotic infusion of normal saline with balloon catheter and to compare the cost of induction between tablet misoprostol and extra amniotic infusion of normal saline   with balloon catheter.

Methods: This randomized controlled study was carried out in the Obstetrics and Gynecology. Department of C.U. Shah Medical College, Surendranagar, from 23th August 2017 to 20th August 2018.

Results: Amongst the 100 participants, 50 induction is done with tab. Misoprostol and 50 induction done with EASIBC. Success rate is higher in tab. Misoprost which is 90.20% and in EASIBC is 75.51%. There were longer induction abortion interval in EASIBC: Need for curettage among Misoprostol is 5 and EASIBC is 9. Major complication like PPH occurred in two cases in induction with tab. Misoprostol, which is managed by further intervention and no death occurred. No major complication occurred in induction with EASIBC.

Conclusions: Excluding the side effects and complications, which are manageable induction with tab. Misoprostol is better than EASIBC in terms of induction abortion interval, effectiveness, acceptability.


Keywords


Extra amniotic infusion of normal saline, Second trimester abortion, Tablet Misoprostol

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References


Barbara Hoffman, Scott Roberts, Robyn Horsager, Vanessa Rogers, Patricia Santiago-Muñoz, Kevin Worley Williams Obstetrics, 24th Edition, Study Guide; McGraw Hill Education, pp no 250

Ministry of health and family welfare of India. Available at https://mohfw.gov.in/acts-rules-and-standards-health-sector

Barbara Hoffman, Scott Roberts, Robyn Horsager, Vanessa Rogers, Patricia Santiago-Muñoz, Kevin Worley Williams Obstetrics, 24th Edition, Study Guide; McGraw Hill Education, pp no 369

Laul RM, Mahale AR, Bhattacharya PR. Termination of mid trimester pregnancies with extraamniotic 0.1% ethacridine lactate. Accurate method for estimation of blood loss. Role of spartein sulfate. Asia Oceania J Obstet Gynaecol. 1984;10(2):185-9.

Kulier R, Kapp N, Gülmezoglu AM, Hofmeyr GJ, Cheng L, Campana A. Medical methods for first trimester abortion. The Cochrane Library. 2011.

Karande SJ, Gunjotikar MS, Comparative study between intravaginal misoprostol and extraamniotic instillation of ethacridine lactacte for second trimester abortion Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2575-9.

Mullin PM, House M, Paul RH, Wing DA, A comparison of vaginally administered misoprostol with extra-amniotic saline solution infusion for cervical ripening and labor induction. AJOG. 2002;187(4):847-52

Amirabi A, Golmohammadlou S, Lak SS, Khabiry L A comparative study of extra – amniotic saline infusion and high dose oxytocin with prostaglandin e2 suppository and high dose oxytocin in pre - induction cervical ripening in second trimester pregnancies. J Urmia Univ Med Sci. 2009,19(4): 295-301.

Shaheen S, Rauf R, Zaigham A, Waqar F. A Comparison of Oral Misoprostol and Extra-amniotic Foley's Catheter with Oxytocin for Induction of Labour at Term.

Vengalil SR, Guinn DA, Olabi NF, Burd LI, Owen J. A randomized trial of misoprostol and extra-amniotic saline infusion for cervical ripening and labor induction. Obstet Gynecol. 1998;91(5):774-9.

Adeniji OA, Oladokun A, Olayemi O, Adeniji OI, Odukogbe AA, Ogunbode O, et al. Pre-induction cervical ripening: transcervical foley catheter versus intravaginal misoprostol. J Obstet Gynaecol. 2005;25(2):134-9.