ON EFFICACY AND ACCEPTABILITY OF EARLY MEDICAL ABORTION BY MIFEPRISTONE WITH ORAL OR VAGINAL MISOPROSTOL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 66
Abstract
BACKGROUND Unsafe abortion is a major public health problem. Globally, 20 million unsafe abortions take place each year and account for 13% of all maternal deaths. According to WHO, 56% of abortions in developing countries are still unsafe even though medical abortion methods have been in use for more than a decade. The main objective of the present study is to compare the efficacy, acceptability, side effects and factors affecting outcome of early medical abortion with oral and vaginal misoprostol after oral mifepristone in inducing early medical abortion up to 49 days. MATERIALS AND METHODS It was an interventional study (non-RCT) conducted on women requesting termination of early pregnancy at the outpatient department of family planning unit with ultrasound confirmed intrauterine gestation of 49 days allocated into two groups. Mifepristone 200 mg was administered on Day 1 followed by 400 mg of oral misoprostol for Group I and 800 mg of vaginal misoprostol for Group II. They were reviewed on Day 14 by ultrasound for completion of abortion and Hb. If abortion was incomplete or bleeding was excessive, curettage was done. RESULTS The two groups were comparable with respect to age, parity and gestational age, socio-economic status and level of education. There was no significant difference in the complete abortion rates for oral (91.1%) and vaginal (92.0%). Mean induction abortion interval was 4.29 hours for oral and 3.5 hours for vaginal (p= 0.023). History of previous abortion was found to be a strong predictor of failure of early medical abortion (p= 0.007). Nausea (24%), vomiting (13%) and fatigue (50%) were more in the oral group. Mean duration of bleeding was 9.4 days in oral and 8.2 days in vaginal group (p= 0.000). Method satisfaction was more among oral group (92.2%) compared to 85.1% in vaginal, but not statistically significant (p > 0.05). CONCLUSION Medical abortion with 200 mg of mifepristone in combination with 400 mg misoprostol orally or 800 mg vaginally after 48 hours was found to be safe, simple, effective, non-invasive and acceptable method.
Authors and Affiliations
Asha Gopi Nath, Ajay Kumar
Keywords
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- EP ID EP231882
- DOI 10.14260/Jemds/2017/1030
- Views 111
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