Evaluate the Efficacy and Safety of Normal Saline Instillation in Induction of Mid Trimester Abortions
Journal Title: Indian Journal of Obstetrics and Gynecology - Year 2018, Vol 6, Issue 2
Abstract
Introduction: A number of methods were tried since decades for Termination of mid trimester pregnancy yet there is no satisfactory, highly effective and safe method. Aim: evaluate the efficacy and safety of normal saline instillation in induction of mid trimester abortions and if it is effective to be considered in area with limited resources. Materials and Methods: Eighty cases who needed mid trimester termination of pregnancy ranging from 16 – 20wks were studied. Out of these 80cases, 40 cases were instilled normal saline and ethacridine Lactate was instilled in 40 cases extraamniotically. Results: The indications of termination of pregnancy were studied obstetric causes for termination of pregnancy were more. Interval between instillation of the agent and expulsion of the Foleys bulb has been observed that in 87.5% of cases in normal saline group and 72.5% of case in ethacridine group the bulb expelled with in 24 hrs of instillation. Interval between the expulsion of bulb to abortion was 70% of cases in ns group and 80% of cases in EL group aborted with in 6 hrs of expulsion of the Foleys bulb. 5% and 15% of cases in NS and EL group expelled in 6–12 hrs of expulsion of bulb respectively. Induction abortion interval is the interval from the instillation of normal saline or ethacridine lactate solution into the extra amniotic space to expulsion of the products of conception. (fetus, placenta and membranes). Mean induction abortion interval in this study in normal saline group is 23.03hrs and ethacridine group is 25.31hrs. Induction abortion interval increased for cases with gestational age 19 – 20 wks. Escalating doses of oxytocin upto 20U starting from 5U given through drip (30 drops/min) until there were moderate uterine contractions after 6 hrs of instillation of agent. It is observed that 12.5% cases in NS group and 5% cases in EL group required no oxytocin as they aborted with in 6 hrs of instillation. 82.5% of cases induced with EASI aborted completely and 90% of cases induced with ethacridine lactate aborted completely. Success rate at 36 hrs of instillation was 87.5% in NS instilled group and 85% in EL instilled group. Success rate time 48 hrs it is 92.5% and 87.5% in NS and EL groups respectively. There were 7 cases of incomplete abortion in NS group and 4 cases in EL group which required check curettage. 2 cases in NS group had fever. 3 cases required reinstillation of agent in NS group as there was no change in bishops score and the bulb didn’t expel at 36 hr of instillation Conclusions: Normal saline is a safe and cost effective drug in mid trimester terminations of pregnancy without any major complications.
Authors and Affiliations
Kuthadi Swarupa
Keywords
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- EP ID EP549466
- DOI 10.21088/ijog.2321.1636.6218.1
- Views 80
- Downloads 0
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