Study of Mifepristone and Misoprostol Vs Misoprostol alone in mid trimester termination of pregnancy in tertiary care hospital

Mahendra. G, Vyshali R, Vijayalakshmi S.


Background: Over the last decade there is an increase in number of second trimester pregnancy termination due to better prenatal screening. Medical methods, using combination of Mifepristone Misoprostol are increasing being used for mid-trimester pregnancy termination. Objective: The present study was conducted with an aim toassess and comparatively evaluate the efficacy of Mifepristone with Misoprostol and Misoprostol alone for mid trimester termination of pregnancy. Methods and Material: A prospective study was conducted on 50 women who presented to us for termination of pregnancy in the mid trimester due to various reasons. These 50 women were divided into two groups of 25 each. In the study group 1, Mifepristone 200mg was given 24hours before intravaginalinsertion of 200mcg of Misoprostol followed by 200mcg every 6hrs until abortion occurs.In the control group 2, only Misoprostol was inserted in the same dose regime. The results were analysed for Primary outcomes i.e. Rate of complete abortion, Induction to abortion interval and failure to achieve complete abortion. Result: Mean induction abortion interval from insertion of the first Misoprostol tablet was significantly shorter in the Mifepristone pre-treated [mean duration7hours] group as compared to Misoprostol alone group [mean duration 18hours]. The mean dose of misoprostol required was significantly less in the study group[around 400mcg] and complete abortion occurred in 100% of casesas compared to control group in whom the mean dose of Misoprostol required was more [around1200mcg], with 8% failure for which Hysterotomy was done. Conclusion: Pre-treatment with Mifepristone 24hr before intravaginal Misoprostol significantly improves induction abortion interval.

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