scholarly journals FIRST TRIMESTER MEDICAL ABORTION PRACTICE IN NORTH EAST INDIA

2021 ◽  
pp. 89-91
Author(s):  
VANREMMAWII ◽  
LALROMAWII ◽  
VANLALHRUAII
Keyword(s):  
Gestational Age ◽  
Medical Abortion ◽  
First Trimester ◽  
Termination Of Pregnancy ◽  
Vaginal Route ◽  
North East India ◽  
North East ◽  
Pre Treatment ◽  
Vaginal Misoprostol ◽  
Group B

Objectives: This study is to compare the efficacy of Mifepristone combined with Misoprostol (Prostaglandin) administered through vaginal and sublingual route in termination of pregnancy of ≤63 days. Methods: Randomized comparative study comprised of 140 pregnant women of ≤63 days gestational age was conducted at Zoram Medical College, Mizoram. Women in group A received 200 mg of Mifepristone orally on day 1 followed by 800 μg of Misoprostol sublingually 36–48 h later, whereas women in group B received 200 mg of Mifepristone orally on day 1 followed by 800 μg of Misoprostol vaginally 36–48 h later. A 2nd dose of 400 μg Misoprostol was given through the same route if abortion process does not start within 4 h. All women who aborted were seen at follow-up and ultrasound pelvis done to confirm complete expulsion of products of conceptions. Results: The total number of primigravida was 34 (24.3%) and multigravida was 106 (75.7%). Complete abortion was seen in 91.4% and 94.28% of per sublingual and per vaginal route group, respectively (p = 0.51). Failure of abortion was 8.57% and 5.71%, respectively, in per oral and per vaginal route (p = 0.51). Conclusion: Sublingual and per vaginal misoprostol after pre-treatment with mifepristone are both an effective method for termination of pregnancy for gestational age of 63 days or less, but the tolerance for sublingual misoprostol was poorer.

scholarly journals Prospective study to compare the efficacy of vaginal misoprostol for first trimester MTP before six weeks and up to 9 weeks

2021 ◽  
Vol 10 (3) ◽  
pp. 1116
Author(s):  
Paresh N. Sheth
Keyword(s):  
Prospective Study ◽  
Gestational Age ◽  
Pregnancy Termination ◽  
Tertiary Care ◽  
Medical Abortion ◽  
First Trimester ◽  
Care Hospital ◽  
Surgical Interventions ◽  
Vaginal Misoprostol ◽  
Group B

Background: Misoprostol is prostaglandin E1 analogue that has been used for medical abortion. MTP has been legalized in India since 1971. Medical abortion refers for early pregnancy termination performed without any primary surgical interventions, usually before 9 weeks (63 days) gestational age. This prospective study was conducted to compare the efficacy of vaginal misoprostol for abortion in women at a gestational age of <6 weeks (42 days) and in woman up to 9 weeks (63 days) gestational age.Methods: This is a prospective study of total 130 women seeking medical termination of pregnancy up to 9 weeks (63 days) gestational age at obstetrics and gynecology department, at a tertiary care hospital Gujarat, India, from May 2018 to May 2019.Results: In result study the overall complete abortion rate was 91.54% In Group A (<6 weeks) complete abortion occurred in 93.3% women. Whereas in Group B (6 to 9 weeks) complete abortion occurred in 90% of women. The two groups did not differ significantly with respect to side effects. Overall, 91.3% women were satisfied with this method and will choose it again if required.Conclusions: This study shows that vaginal misoprostol alone regimen is highly effective and well tolerated method in Indian women requiring MTP up to 63 days gestational age. However better efficacy maybe achieved at gestational age < 6 weeks (42 days). 

scholarly journals Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

2019 ◽  
Vol 8 (8) ◽  
pp. 3368
Author(s):  
Nida Khan ◽  
Anita M. Kant ◽  
Pooja C. Thukral ◽  
Mohammad Saquib
Keyword(s):  
Side Effects ◽  
Group Versus ◽  
First Trimester ◽  
Comparable Efficacy ◽  
P Value ◽  
Vaginal Route ◽  
Trimester Abortion ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: To compare the effectiveness, side effects, and patient satisfaction of buccal versus vaginal misoprostol administration in first trimester abortions.Methods: Women opting for first trimester abortion received oral Mifepristone followed 48 hours latermisoprostol. Group A received Misoprostol via buccal route whereas group B received Misoprostol vaginally. A comparative analysis using SPSS was done.Results: Giving 800µg Misoprostol by either buccal or vaginal route after oral Mifepristone have comparable efficacy in terms of complete abortion rate (96% in buccal group versus 98% in vaginal group; p value = 0.495), failure rate being statistically similar (4% versus 2%). Drug abortion interval was comparable in the two groups. (11.16 hour in buccal group and 12.32 hours in vaginal group). Few side effects like nausea and vomiting, shivering, diarrohea was significantly higher with vaginal Misoprostol while abdominal cramps, altered taste were found more with the buccal group.Conclusions: Buccal Misoprostol is comfortable and easier to administer when compared to other routes and it has potential to be developed as a self-administered regimen. Buccal Misoprostol is as efficacious as vaginal Misoprostol with significantly lesser side effects up to 7 weeks of period of gestation.

scholarly journals Combination of mifepristone and misoprostol: an effective method of medical abortion upto gestational age of 49 days

2017 ◽  
Vol 6 (7) ◽  
pp. 2923 ◽  
Author(s):  
Seema C. Kshirsagar Kshirsagar ◽  
Uma Nitin Wankhede
Keyword(s):  
Gestational Age ◽  
Medical Abortion ◽  
Termination Of Pregnancy ◽  
Prostaglandin Analogue ◽  
Medical Termination Of Pregnancy ◽  
Medical Regimen ◽  
Medical Termination ◽  
Surgical Evacuation ◽  
Vaginal Misoprostol ◽  
One Year

Background: A combination of antiprogesterone mifepristone and prostaglandin analogue misoprostol provides an effective non surgical method for termination of pregnancy up to gestational age of 49 days. Objective of present study was to assess the efficacy of this medical regimen for termination of pregnancy up to 49 days of pregnancy.Methods: A hospital based retrospective study was carried out in Department of Obstetrics and Gynecology in Sassoon General Hospital, Pune, India for a period of one year where 30 women requesting for medical abortion were studied. The medical regimen used was mifepristone 200 mg orally followed 48 hours later by misoprostol 800 microgram administered in posterior vaginal fornix.Results: The overall success rate of this regimen was 90%. Where success was defined as achieving complete abortion without needing surgical evacuation. Surgical evacuation was needed in 3 (10%) patients i.e. for incomplete abortion.Conclusions: Combination of oral mifepristone 200mg followed 48 hours later by vaginal misoprostol 800mcg is an effective method of medical termination of pregnancy.

scholarly journals VAGINAL AND ORAL MISOPROSTOL FOLLOWING MIFEPRISTONE ADMINISTRATION IN MEDICAL TERMINATION OF PREGNANCY UP TO 49 DAYS: A COMPARATIVE STUDY

2019 ◽  
pp. 1-3
Author(s):  
DIVYA VARDAINI
Keyword(s):  
Comparative Study ◽  
Termination Of Pregnancy ◽  
Vaginal Route ◽  
Control Groups ◽  
Routes Of Administration ◽  
Medical Termination Of Pregnancy ◽  
Oral Misoprostol ◽  
Medical Termination ◽  
Gastrointestinal Side Effects ◽  
Vaginal Misoprostol

Objective: The objective of this study was to compare and evaluate the efficacy, safety, adverse effects, and patient compliance of vaginal versus oral misoprostol in medical termination of pregnancy after tablet misoprostol up to 49 days of gestation. Methods: A comparative study of 100 patients divided randomly assigned to two control groups. Results: The study showed that 200 mg mifepristone followed by 800 mcg vaginal misoprostol is more effective for medical termination in gestational age up to 49 days as compared to 200 mg mifepristone followed by 400 mcg oral misoprostol. Conclusion: While both routes of administration are safe, gastrointestinal side effects are more with oral misoprostol. The vaginal route is more acceptable to the patients enrolled in the study.

scholarly journals Comparative effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen of mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion

2018 ◽  
Vol 7 (6) ◽  
pp. 2449
Author(s):  
Arunima Saini ◽  
Preet Kamal Bedi ◽  
Nisha Bhagat
Keyword(s):  
Gestational Age ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Simultaneous Administration ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Group A ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Group B

Background: In second trimester abortion, medical methods are preferred. Prostaglandins are the most widely used. Amongst them, misoprostol is the most commonly used. Thus, the study was conducted to delineate the effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion.Methods: It was a prospective, single centered, comparative study conducted on 50 patients in Department of Obstetrics and Gynaecology, GMC, Amritsar coming for second trimester abortion, either elective or emergency, with gestational age between 12-20 weeks. Initially, 53 patients were enrolled in the study, 3 patients dropped out at different stages of study. Finally, 50 patients were enrolled and divided into two groups of 25 patients each by 1:1 randomization. In Group-A, mifepristone 200 mg orally along with misoprostol 600µg vaginally were given simultaneously, followed by 400 µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Group-B initially received mifepristone 200 mg per oral followed by 12 hours later misoprostol 400µg vaginally and then 400µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Primary outcome measure was effectiveness of regimen in complete abortion, which was confirmed on pelvic ultrasound 1-week after the last dose. Secondary outcome measure was to compare the induction abortion interval (IAI), dose of misoprostol required and adverse drug reaction (ADR) among both the regimens. P-value <0.05 was taken as statistically significant.Results: Mean age in Group-A was 25.68±3.79 years while in Group-B was 23.40±2.73 years. Both the regimens had success rate of 76% for complete abortion. However, IAI in Group-A was 5.9±4.47 hours whereas in Group-B was 9.6±5.07 hours, which was statistically significant (p= 0.009). A statistically significant difference was also observed in the mean dose of misoprostol between two groups that is, 1000±200µg and 1425±437.41µg respectively (p=0.01). Gestational age was related to IAI from 13 to 17.6 weeks in both groups (p=0.01) while no significant relation was seen between them in more than 17.6 weeks of gestation (p=0.63).Conclusions: Simultaneous administration of mifepristone and misoprostol showed better results than interval regimen in term of significant lesser induction abortion interval, lower dosages of misoprostol required with comparable success rates.

scholarly journals A comparative study of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy

2019 ◽  
Vol 8 (2) ◽  
pp. 498
Author(s):  
Ruchi Gupta ◽  
Krishna Priya Banerjee ◽  
Reena Pant
Keyword(s):  
Success Rate ◽  
Medical Abortion ◽  
Oral Route ◽  
Termination Of Pregnancy ◽  
Second Trimester ◽  
Oral Misoprostol ◽  
Sublingual Misoprostol ◽  
Group A ◽  
The Mean ◽  
Group B

Background: The objective of this study is to assess the effectualness and safety of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy.Methods: This institution based contingent study was conducted on 220 women requesting for mid-trimester termination of pregnancy between 12-20 weeks with legal indication as per Govt. MTP act. After excluding the women as per exclusion criteria, they were randomly allocated into two groups (Group A Sublingual, Group B Oral), the women received 200 mg oral mifepristone followed by sublingual or oral misoprostol 400µg three hourly for a maximum of 5 doses 48 hours later. The course of misoprostol was reiterated if women failed to abort in 24 hours.Results: The mean induction-abortion interval of Group-A and Group -B was 4.02±1.39 hours and 6.44±1.79 hours respectively. The mean dose of misoprostol in Group–A and Group-B was 680±220.4µg and 1003.6±274.9µg. Hence mean Induction-abortion interval and dose were shortened in  Group-A as compare to Group-B (p <0.05). There was 100% success rate noticed via both routes. Evacuation was done in 4 (3.64%) women in Group-B as compare to only 1 (0.91%) in Group-A . The acceptability was significantly more in Group-B (100%) as compare Group-A (52.73%), probably because of unpleasant taste of sublingual misoprostol. All side effects (Nausea, pain, headache, and diarrhea) were common in both the Groups, only fever was significantly more common in sublingual group as compare to oral group (p<0.05).Conclusions: From present study authors conclude that, sublingual misoprostol when combined with mifepristone is effective for medical abortion in second trimester in terms of effectualness, endurability and success rate than oral route.

scholarly journals Oral and vaginal route of misoprostol for induction of labour: a comparative study

2019 ◽  
Vol 8 (5) ◽  
pp. 1956
Author(s):  
Deepti D. Sharma ◽  
Kavita A. Chandnani
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Vaginal Route ◽  
Oral Misoprostol ◽  
Group A ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: Induction of labour can be defined as “Artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods, for purpose of vaginal delivery.” The key factor for a successful induction is the status of cervix, its form, consistency and dilatation which is determined by the Bishop score. In case of unfavourable cervix or in the pregnancies remote from the term; prostaglandins are more effective than any other method of induction. Introduction of misoprostol, PGE1 analogue, for the induction of labour in 1993 and its approval for clinical use by ACOG (American College of Obstetrics and Gynecology) in 1999 has been the most significant advancement. It is the latest drug for induction of labour which is cheap and stable at room temperature and is being used worldwide in different doses and by various routes. We compared the most commonly preferred two routes; vaginal and oral in terms of success of induction and noted the adverse events and side effects in both routes.Methods: This was a prospective comparative study carried out at SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, Vadodara, Gujarat, 200 patients who required induction of labour were recruited after applying inclusion and exclusion criteria and were randomly divided in two groups- Group A meant to receive 50µg oral misoprostol, Group B - meant to receive 25µg vaginal misoprostol repeated 4 hourly up to maximum of five doses. Progress of labour was charted on the partograph. The mean induction delivery interval, mode of delivery, maternal and neonatal outcomes and complications were observed.Results: The mean induction to delivery interval was significantly less in vaginal group than oral (23.3±12.4 hours in oral vs. 17.3±10 hours in vaginal). Vaginal delivery and cesarean section rates were comparable in both groups (76% in Group A vs. 72% in Group B for vaginal delivery, 18% vs. 20% for Cesarean section, respectively). 58% patients in Group A required more than two doses as compared to 39% in group B, though the difference was statistically not significant. Significant number of patients required added oxytocin administration in Group A (72%). No major complications or adverse events were observed. Neonatal hyperbilirubinemia was seen more in Group A.Conclusions: Both Oral misoprostol in a dose of 50μg and vaginal misoprostol 25 μg every four hours, to a maximum of five doses, have the potential to induce labour safely and effectively. The vaginal route however is beneficial in effecting delivery in lesser time with few numbers of doses as compared to oral route.

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