Effect of the thyroid status in pregnant patients on the outcome in medical abortion

Background: Medical abortion has the potential to expand abortion services, where surgical services are limited, and to expand women’s choice of abortion method and experience. Objective of present study was to compare the outcome after medical abortion in euthyroid and hypothyroid pregnant patients.Methods: A longitudinal study was carried out in pregnant patients before 9 weeks of pregnancy who wanted termination of pregnancy. Women were divided into two groups. Group I (n = 100) comprised euthyroid patients who acted as control group, whereas group II (n = 58) included patients having subclinical or overt hypothyroidism. All the patients were given 200 mg of mifepristone orally followed by 800 µg of misoprost vaginally 36 to 48 hours later. these patients were followed for 2 weeks. In all the patients, hemoglobin estimation and ultrasound were done during follow-up.Results: Average hemoglobin in the study group was 9.5 gm%, whereas in control group it was 11.1 gm%, which was statistically significant. the fall in hemoglobin after 2 weeks of the drug intake was also significant in control as well as the study group. About 13.79% patients in the study group had to undergo emergency evacuation of uterus within 24 hours for complaints of severe bleeding. In control group, no emergency curettage was done within 24 hours, the difference being highly significant. Mean duration of bleeding was also more in the study group. About 28.57% patients in the study group revealed products of conception on ultrasound after 2 weeks in comparison with 11.57% in the control group, which was also statistically significant (p = 0.008). A total of 41% patients in the study group had to undergo uterine curettage, which was highly significant (p = 0.000).Conclusions: Present study showed that patients having clinical or subclinical hypothyroidism have more failure rates, more chances of excessive bleeding, increased duration of bleeding, resulting in decrease in hemoglobin levels in already anemic patients. Also, the rate of operative intervention was unusually high in hypothyroid group