Rectal misoprostol vs. vaginal misoprostol for first trimester termination of pregnancy

2004 ◽  
Vol 85 (1) ◽  
pp. 64-65 ◽  
Author(s):  
T. Okman-Kilic ◽  
M. Kucuk
Author(s):  
Shivani Gupta

Background: Unsafe and illegal abortions are one of the major problems in women health in India. Despite legal approval for medical termination of pregnancy in 1971, unsafe abortion still remains the third leading cause of maternal deaths in the country, contributes eight percent of such deaths annually. The objective of this study was to study efficacy of Mifepristone 200 mg orally followed 36-48 hours later by Misoprostol 800 microgms per vaginally in women undergoing medical termination of early pregnancy (up to 63 days of gestational age).Methods: The present study included 60 pregnant women requesting termination of pregnancy in the first trimester. Women who fulfilled the inclusion criteria were included in the study. Women without medical or surgical contraindications to Mifepristone and Misoprostol were included. Patients with previous caesarean sections were also included.Results: In our study 60 women were included, majority were in age group 20-29 years of age and majority of cases were primipara or multipara. The success rate in terms of complete abortion was 97%, 2% needed surgical evacuation and 1% lost to follow up. Side effects were nausea, vomiting, diarrhoea, abdominal cramps, pyrexia etc. The method proved to be safe, effective, cheap, non-invasive and has minimal or no complications.Conclusions: Medical termination of pregnancy with oral mifepristone and vaginal misoprostol is an effective method for first trimester abortion. The prerequisite for the method is patient counselling, patient participation and willingness for regular follow up and to report any complication. Hence this method comes out to be a safe alternative to surgical method which is invasive and costly.


Author(s):  
Latika R. Mehta ◽  
Grishma P. Agrawal

Background: Authors estimate that 15.6 million abortions (14.1 million-17.3 million) occurred in India in 2015. Incomplete abortion is a known disadvantage of medical method of abortion reported in 0.2-3% of cases. Though Misoprostol can be used with different routes including oral, sublingual and vaginal, few evidences are available in drug effectiveness as well as its related side effects when used through different routes and more so in India. The present study is aimed to compare the efficacy of misoprostal in first trimester abortion when taken vaginally as compared to orally. Thus, whichever route results in lower rates of incomplete abortions, can be employed in our health set up, minimizing the complications of failed first trimester MTP.Methods: An experimental study was conducted on 74 women seeking termination of pregnancy within 9 weeks of amenorrhea during the period of 9 months in a tertiary care institute. Tablet mifepristone 200 mg was given to all participants. After 48 hours, 37 women were given 800 mcg tablet of Misoprostol for oral consumption while other 37 women were given 800 mcg Misoprostol for self-administering vaginally. Abortion status and complications were checked.Results: The complete abortion rates in vaginal group and oral group were 97.3% and 86.49 % respectively. Satisfaction was more in case of vaginal misoprostol, while side effects were similar in both groups.Conclusions: Mifepristone with vaginal misoprostol was more effective as compared to oral misoprostol for first trimester abortion.


Author(s):  
VANREMMAWII ◽  
LALROMAWII ◽  
VANLALHRUAII

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.


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