Second trimester abortion management have undergone tremendous change with advent of prostaglandin analogues. Medical methods are safer comparatively, non-invasive, have no anaesthesia complications and have advent over surgical methods. The present study is compare the abortifacient efficacy of mifepristone with vaginal misoprostol and using misoprostol alone in the mid trimester abortion.
AIM AND OBJECTIVES:
To compare the abortifacient effect of mifepristone with vaginal misoprostol and misoprostol alone in second trimester termination of pregnancy. Induction-abortion interval, success rate, outcome were compared.
To compare side-effects and complications.
To compare the cost effectiveness.
METHODOLOGY:
Patients requesting abortion in their second trimester are randomly allocated into two groups. Sample size:100 GROUP-1-50-Mifepristone + vaginal misoprostol GROUP-2- 50- vaginal misoprostol alone.
DISCUSSION:
Second trimester termination of pregnancy has tremendous improvement in management by the usage of prostaglandins. In this study, mean age of patients in mifepristone and misoprostol
group was 25.54 years and in misoprostol group it was 25.22.yrs. The age distribution is found to be maximum among 21-25 yrs and above 30yrs it was less.
In this current study patients with atleast one prior delivery constitute for 22% in mifepristone+ misoprostol group, 30% in misoprostol group But in the study conducted by JAN E DICKINSON it was 57.8% in mifepristone+ misoprostol group and in misoprostol it was 60.3%.
In this study, the mean gestational age in mifepristone=misoprostol group was18.22 weeks and in misoprostol group it was 18.40weeks. Mifepristone given prior to prostaglandins in second trimester abortions resulted in shorter induction-abortion interval and success rate is found to be
high though the cost is high. In Mifepristone + misoprostol, 80% aborted successfully, but in
misoprostol group only 36% aborted within 12hrs. In Mifepristone + misoprostol group 100% aborted successfully at 24and 48 hrs and in misoprostol group it was 98 % and was compared with
other studies.
CONCLUSION:
Comparing Mifepristone and Vaginal Misoprostol combination with vaginal misoprostol alone for second trimester pregnancy termination, it was observed that Mifepristone with vaginal misoprostol combination group is associated with shorter induction abortion interval and 100% success rate. The complete abortion rate, success rate and side effects were comparable in both group