scholarly journals Comparative study between intravaginal misoprostol and extra-amniotic instillation of ethacridine lactacte for second trimester abortion

2017 ◽  
Vol 6 (6) ◽  
pp. 2575
Author(s):  
Suryaprakash Jagdevappa Karande ◽  
Meena Shantanu Gunjotikar
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Ethacridine Lactate ◽  
Second Trimester Pregnancy ◽  
Group A ◽  
Second Trimester Abortion ◽  
Group B

Background: The methods of terminating pregnancy in the first trimester are simple, safe and effective. Factors like lack of knowledge about availability of MTP services, ignorance, denial of pregnancy, fear of society may account for decrease in number of first trimester abortions. The aims of the present study were to compare the efficacy, induction abortion interval and side effects of intravaginal misoprostol with extra amniotic installation of ethacridine lactate for second trimester abortion.Methods: 60 women coming to MTP clinics requesting second trimester pregnancy termination between 12 to 20 weeks were selected. Detail history and examination was carried out in each patient. They divided into two groups, Group A (30) intravaginal misoprostol 400 initially followed by 400 micrograns every 6 hourly if required. Group B (30) extra-amniotic 0.1% ethacridine lactate 150 cc.Results: In Group A success rate was 100% while in Group B it was 76.66%, which is highly statistically significant (P< 0.01). Mean I – A interval in Group A was 14.58+5.25 hours was highly significantly less than in Group B, it was 33.91 + 3.97 hours (p<0.0001). In Group A complete abortion has occurred in 28 cases (93.33%) and in Group B in 12 cases (52.17%).Conclusions: We conclude that, as compared to extra-amniotic instillation of ethacridinelactate intravaginal misoprostol is the preferred regimen in second trimester abortion because of its high efficacy, shorter induction abortion interval, high incidence of completeness of abortion, low incidence of side effects and better tolerance by the patient. 

scholarly journals Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

2018 ◽  
Vol 7 (3) ◽  
pp. 888
Author(s):  
Abhijeet Kumar ◽  
Raju Agarwal
Keyword(s):  
Side Effects ◽  
Failure Rate ◽  
Pregnancy Termination ◽  
Termination Of Pregnancy ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Trimester Pregnancy ◽  
Second Trimester Pregnancy ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol

Background: The addition of dinoprostone gel (PGE2) to standard regimen of second trimester abortion using vaginal misoprostol (PGE1) reduces failure rate and decrease induction abortion time interval. We evaluated the role and efficacy of vaginal dinoprostone gel with vaginal misoprostol in women undergoing second trimester abortion. Objective of present study was to assess the safety and effectiveness of vaginal dinoprostone gel plus vaginal misoprostol for second trimester termination of pregnancy.Methods: This study was a prospective cohort involving 100 women with 12-20 weeks gestation requesting termination of pregnancy. In study group 0.5mg dinoprostone gel applied vaginally followed by 400µg misoprostol every four hourly (max 3 doses) after six hours of dinoprostone gel application. The mean age of the women study was 27.2 years and mean gestational age was 18.9 weeks. The primary effectiveness of the study was the efficacy of the treatment to terminate pregnancy at 20 hrs. Secondary outcomes were induction abortion interval, failure rate, side effects. statistical analysis of study was carried out using chi square test.Results: At 20 hours, the complete abortion rate was 100%. Within 16 hours 98% women aborted without any significant side effects. Mean induction abortion interval was 14.56 hours.Conclusions: Combination of vaginal dinoprostone gel (PGE2) plus misoprostol (PGE1) is effective, safe and alternate method for second trimester pregnancy termination with. In this protocol induction to abortion interval time is less as compared to other methods of second trimester pregnancy termination.

scholarly journals Mifepristone and Misoprostol Vs Misoprostol Alone in Second Trimester Termination of Pregnancy

2018 ◽  
Vol 56 (213) ◽  
pp. 856-860
Author(s):  
Deepa Shah ◽  
Pappu Rijal ◽  
Achala Thakur ◽  
Rubina Rai
Keyword(s):  
Side Effects ◽  
Termination Of Pregnancy ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Highly Effective ◽  
Group A ◽  
Complete Failure ◽  
Second Trimester Abortion ◽  
The Difference ◽  
Group B

Introduction: During the last decade, medical methods for second trimester abortion have considerably improved and become safe and more accessible. The combination of mifepristone and misoprostol is now an established and highly effective method for second trimester abortion. But where mifepristone is not available or affordable, misoprostol alone has also been shown to be effective. The objective of this study is to compare the efficacy of mifepristone with misoprostol and misoprostol alone for second trimester termination of pregnancy. Methods: It is a comparative study conducted on 60 patients from 13 to 18 weeks of gestation admitted for second trimester termination on legal indications. Results: Mean induction abortion interval was comparable in both the groups. Of the 30 cases in each group, nine cases in each Group A and six cases in Group B had incomplete/failed expulsion. Among these 15 cases, only nine required check curettage for complete evacuation while others received oxytocics only for completion. The distribution of these cases was also comparable in both the groups. Only one patient in Group B had complete failure of expulsion and underwent surgical evacuation. However, the difference in dosage of misoprostol required for complete expulsion and incidence of side effects were significantly higher in the group B. Conclusions: Mifepristone and misoprostol combined together is now an established, highly effective and safe method for medical method of second trimester termination. However, when mifepristone is not available or affordable, misoprostol alone can also be used effectively, although a higher total dose is needed and side effects are higher than with the combined regimen.

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 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 Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion

2018 ◽  
Vol 7 (11) ◽  
pp. 4545
Author(s):  
Michelle N. Fonseca ◽  
Vernica Sah
Keyword(s):  
Side Effects ◽  
Foley Catheter ◽  
Medical Abortion ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Sequential Administration ◽  
Group A ◽  
Low Incidence ◽  
Vaginal Misoprostol ◽  
Group B

Background: Abortions are one of the most commonly performed procedures in gynaecological departments worldwide. They are still a major problem in developing countries contributing to a significant percentage of maternal morbidity and mortality. The main objective of this study is to compare the efficacy, side effects and acceptability of intracervical Foley and oral Mifepristone both followed with sequential administration of vaginal misoprostol for second trimester medical abortion.Methods: This was a prospective randomized trial of 36 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation between 12 to 20 completed weeks. Intracervical Foley catheter with administration of misoprostol (200µg) vaginally was done for Group A. Mifepristone 200mg was administered on day one followed by misoprostol (200µg) vaginally, 48 hours later, to Group B. Both groups received misoprostol (200µg) vaginally at 4 hourly intervals. Completeness of abortion was assessed, and surgical evacuation was performed, if abortion was found to be incomplete.Results: The two groups were comparable with respect to age, parity and gestational age. 83-89% of the women in both the groups had complete abortion. The mean induction abortion interval was 20.11 hours in Group A and 54.77 hours in Group B, which was statistically significant. Side effect profile was comparable in both groups however the intensity and the duration of persistence of pain was greater among patients from Group A.Conclusions: Authors conclude that medical abortions with both methods were found to be safe, effective, inexpensive and acceptable methods. Whereas a shorter induction abortion interval was observed in the Foley induction group, induction with mifepristone was the preferred regimen in second trimester abortion because of its high efficacy, low incidence of side effects, better tolerance by the patients and due to lower dose of misoprostol required following mifepristone administration.

scholarly journals Randomized comparison of vaginal and sublingual misoprostol with mifepristone priming in termination of second trimester pregnancy

2019 ◽  
Vol 7 (10) ◽  
pp. 3869
Author(s):  
Shrikrushna Vasant Chavan ◽  
Niraj Nilkanth Mahajan ◽  
Arundhati Gundu Tilve
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
Medical Abortion ◽  
P Value ◽  
Second Trimester ◽  
Open Label ◽  
Sublingual Misoprostol ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: Sublingual Misoprostol 200 ug 4 hrly is as effective or less effective than vaginal Misoprostol 200ug 4hrly with 200mg oral Mifepristone in termination of second trimester pregnancy.To compare effectiveness, side-effects, and patient satisfaction of sublingual vs vaginal misoprostol administration.Methods: It was prospective randomized open label study. 60 women 13-20 weeks of gestation with a valid legal indication for termination of pregnancy as per MTP act in INDIA were enrolled for study, randomly divided into Group A- Sublingual (n=30) group B-Vaginal (n=30). For group A, 200 mg of Mifepristone was given, 48h later Misoprostol 200 µg was given sublingually 4hrly up to a maximum of 5 doses. If abortion does not occur, the pregnancy was terminated with vaginal misoprostol, in group A. Same procedure repeated in group B. If abortion fails to occur after 5 doses, then second course of vaginal misoprostol was given in group B. Failure of procedure was defined as failed expulsion of foetus at 48 hrs. Results: Mean induction-abortion interval in vaginal group was 12.8±4.38h and 11.47±4.42h in sublingual group was comparable with insignificant p value (p=0.136). All the side effects were comparable in both groups. The overall success rate was 93.3% in the sublingual group while it was 100% in the vaginal group.Conclusion: Vaginal misoprostol with oral mifepristone priming in second -trimester medical abortion has a shorter time to pregnancy termination compared with a sublingual regimen. However, both the routes are equally effective for induction of abortion.

National survey of attitudes towards pregnancy termination procedures among anaesthesiology residents in the US

Sexual Health ◽  
2018 ◽  
Vol 15 (5) ◽  
pp. 477
Author(s):  
Paris Stowers ◽  
Aneesa Thannickal ◽  
Martha Wojtowycz ◽  
Jodi Wallis ◽  
Zevidah V. Reiss
Keyword(s):  
Maternal Health ◽  
Online Survey ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Second Trimester ◽  
Fetal Anomalies ◽  
Trimester Abortion ◽  
The Us ◽  
Second Trimester Abortion ◽  
Abortion Access

Anaesthesiologists are vital to abortion access in the US. An online survey of 215 anaesthesiology residents assessed attitudes towards abortion. Among the surveyed residents, first-trimester abortion was more acceptable than second-trimester abortion (P < 0.001). Few respondents objected to abortion in cases of fetal anomalies or maternal health indications. Further, 77.3% of surveyed residents reported past participation in abortion procedures, including 77.8% of residents with objections to abortion in some circumstances. Anaesthesiology residents who are female, childless and non-religious were more likely to find first-trimester abortion acceptable.

scholarly journals Second Trimester Abortion with Vaginal Misoprostol: Is There Any Advantage with Prior Mifepristone Priming? A Comparative Study

2012 ◽  
Vol 4 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Partha Mukhopadhyay ◽  
Tara Sankar Bag ◽  
Amit Kyal ◽  
Anup Bhuniya ◽  
Tushar Kanti Saha
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Careful Examination ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Group A ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Ideal Method

ABSTRACT Objective Second trimester medical termination of pregnancy (MTP) can be done by surgical or nonsurgical methods or by various combinations of the two. Every method has its advantages and disadvantages. An ideal method would be one which was safe, quick and 100% effective, inexpensive and without any immediate or late side-effects. However, in the absence of such, various methods in synergistic combinations have been tried to come close to an ideal method. The successes of medical method now appear to be useful in MTP even in second trimester of pregnancy. Our objective is to investigate the effectiveness of only vaginal misoprostol and compare with oral mifepristone plus vaginal misoprostol in second-trimester induction abortions (≥12 and ≤20 weeks). Methods The patients are selected after careful examination and necessary investigations were divided into group A (n = 62) which received 400 μg of vaginal misoprostol followed by 200 μg vaginal misoprostol 4 hourly till expulsion of fetus or a maximum dose of 2000 μg and group B (n = 60) which received 200 mg of oral mifepristone followed 48 hours later by vaginal misoprostol as in group A. Main outcomes measured were efficacy, blood loss, induction-abortion interval and complication. Results The present study showed that the both methods were effective in 2nd trimester MTP. Average blood loss was lesser in group B (131.66 ml) compared to group A (150 ml). Induction abortion interval was shorter in group B (6.62 hours) than in group A (12.19 hours). Ninty percent of group B and 80.7% of group A had no complications. Success rate was higher in group B. Conclusion Therefore, in our study, pretreatment mifepristone followed by misoprostol was found to be a very effective regimen for 2nd trimester abortion with lesser complications and higher efficacy. How to cite this article Mukhopadhyay P, Bag TS, Kyal A, Bhuniya A, Saha TK. Second Trimester Abortion with Vaginal Misoprostol: Is There Any Advantage with Prior Mifepristone Priming? A Comparative Study. J South Asian Feder Obst Gynae 2012;4(1):25-27.

scholarly journals Randomized control trial to compare the effectiveness of mifepristone followed by misoprostol at 12 hours interval versus misoprostol alone in second trimester medical termination of pregnancy

2018 ◽  
Vol 7 (8) ◽  
pp. 3299
Author(s):  
Preet Kamal Bedi ◽  
Arunima Saini
Keyword(s):  
Side Effects ◽  
Cervical Dilatation ◽  
Secondary Outcome ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Mifepristone priming in second trimester abortions not only decreases the induction-abortion interval (IAI) but also lessens the total misoprostol dose required and hence reduces adverse effects. The present study aims to compare the role of mifepristone priming 12 hours before misoprostol administration so as to increase patient compliance and shorten the duration of hospital stay.Methods: This prospective study was conducted over a period of one year, on 50 patients requiring second trimester abortion, at Department of Obstetrics and Gynaecology, Government Medical College, Amritsar. The patients were divided into two groups with 1:1 randomization. In Group A, 25 women were given tablet mifepristone 200 mg orally followed 12 hours later by tablet misoprostol 400 µg per vaginum followed by the same dose 3 hourly for a maximum of five doses per 24 hours. In group B, 25 women received only tablet misoprostol 400 µg vaginally in the posterior fornix followed by the same dose 3 hourly for a maximum of five doses per 24 hours. Primary outcome was to compare the completeness of expulsion of products of conception by pelvic ultrasound after 48 hours of the last dose administered. Secondary outcome was to compare the Induction abortion interval (IAI), mean dose of misoprostol required, side effects, effect of parity, gestational age and cervical dilatation on IAI with both the regimens used.Results: The success rate was 76% in group A and 64% in group B. The mean induction abortion interval in group A was 8.9±4.70 hours whereas in group B, it was 13.14±6.03 hours and this difference was statistically significant (p = 0.008). A statistically significant difference was also observed in mean dose of misoprostol required in group A and B being 1232.00±398.60 µg and 1584.00±423.94 µg respectively (p=0.004). The side effects were less in group A. Parity and cervical dilatation hold an inverse relation with the mean IAI whereas it has a direct relation with the gestational age.Conclusions: Regimen involving mifepristone priming 12 hours before misoprostol is better than misoprostol alone regimen with significant reduction in IAI, mean dose of misoprostol and less side effects. 

scholarly journals Study of role of tablet misoprostol and extra amniotic normal saline in second trimester abortion

2018 ◽  
Vol 8 (1) ◽  
pp. 234
Author(s):  
Zinkal P. Kothadiya ◽  
Bhavesh B. Airao ◽  
Bipin R. Shah
Keyword(s):  
Normal Saline ◽  
Pregnancy Termination ◽  
Balloon Catheter ◽  
Major Complication ◽  
Controlled Study ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Mechanical Methods ◽  
Second Trimester Pregnancy ◽  
Second Trimester Abortion

Background: Second-trimester pregnancy termination comprises 10 to 15 percent of the approximately 42 million abortions performed annually worldwide.  Second-trimester procedures can be performed either with medication or by mechanical methods (Foleys catheter) or surgically by dilation and evacuation (D and E) or hysterotomy. The objective of the present study was to evaluate and compare the efficacy and safety of Tablet Misoprostol and extra amniotic infusion of normal saline with balloon catheter in second trimester abortion, to find out the maternal outcome, to compare the induction- to delivery interval between tablet misoprostol and extra amniotic infusion of normal saline with balloon catheter and to compare the cost of induction between tablet misoprostol and extra amniotic infusion of normal saline   with balloon catheter.Methods: This randomized controlled study was carried out in the Obstetrics and Gynecology. Department of C.U. Shah Medical College, Surendranagar, from 23th August 2017 to 20th August 2018.Results: Amongst the 100 participants, 50 induction is done with tab. Misoprostol and 50 induction done with EASIBC. Success rate is higher in tab. Misoprost which is 90.20% and in EASIBC is 75.51%. There were longer induction abortion interval in EASIBC: Need for curettage among Misoprostol is 5 and EASIBC is 9. Major complication like PPH occurred in two cases in induction with tab. Misoprostol, which is managed by further intervention and no death occurred. No major complication occurred in induction with EASIBC.Conclusions: Excluding the side effects and complications, which are manageable induction with tab. Misoprostol is better than EASIBC in terms of induction abortion interval, effectiveness, acceptability.

Sign in / Sign up

Export Citation Format

Share Document