Comparative Study of Sequential Dose Misoprostol and Trans-Cervical Extra Amniotic Iodine Saline for Second Trimester Medical Termination Of Pregnancy
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Background: Second trimester termination of pregnancy is a controversial topic since long having many moral, emotional, social, technical and legal issues. Old methods are being increasingly replaced by prostaglandin analogues like PGE1, PGE2, PGF2 alpha etc. But there is need for more studies to establish their regime, efficacy, contraindications, complications and cost effectiveness. Objective: To compare acceptability, safety, efficacy, complications, induction-abortion interval and cost effectiveness of Misoprostol and transcervical extra amniotic Iodine saline method for mid trimester termination of pregnancy. Method: Sixty women with valid legal indication of termination of 13-20 weeks of pregnancy were randomized in 2 groups. In group A, 400 μg of Misoprostol was given vaginally every 3 hours for a maximum of 5 doses (FIGO Protocol). In group B, 150 ml of 0.17% of sterile Povidone Iodine saline was instilled extra-amniotically with transcervical Foley’s catheter. Incidence and indications of abortion, success rate, induction-abortion interval, complications and client satisfaction were studied and analyzed. Results: Most common indication of second trimester termination of pregnancy was eugenic cause (73.33%). The mean induction-abortion interval was 16.84 hours in Misoprostol group and 25.77 hours in Iodine saline catheter group. The rate of complete abortion at 48 hours was 76.66% for Misoprostol and 63.33 % for Iodine saline group. The average cost per procedure was lesser for Misoprostol group as compared to Iodine saline group. Rate of side-effects was more with Iodine saline (66.66%) as compared to Misoprostol (50.33%). Conclusion: Misoprostol is highly efficacious with shorter induction – abortion interval, lesser need for post-abortal evacuation, lesser side effects and complications, higher safety profile, better cost effectiveness and hence better overall client satisfaction but in conditions where Misoprostol or other prostaglandins are better avoided or not available, Iodine saline catheter method seems to be a time tested, cheap, easily available and equally effective method.
Authors and Affiliations
Pankhuri Goyal Busar, Bipin M Nayak, Seema Sharma
Keywords
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- EP ID EP536631
- DOI 10.21276/ijmrp.2018.4.5.006
- Views 54
- Downloads 0
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