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 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 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.

scholarly journals Efficacy of combination of tablet mifepristone and misoprostol for first trimester pregnancy termination at different gestational age

2017 ◽  
Vol 7 (1) ◽  
pp. 248
Author(s):  
Poonam Bhojwani ◽  
Pragati Meena ◽  
Gajendra Singh Verma
Keyword(s):  
Side Effects ◽  
Gestational Age ◽  
Pregnancy Termination ◽  
First Trimester ◽  
P Value ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Medical method of abortion is a safe, effective and affordable method for first trimester termination. However, nausea, vomiting, diarhoea, excess bleeding and incomplete abortion are known side effects. The aim of study was to compare the success rate of abortions in both groups, to compare the induction-abortion interval in both groups and to study the side effects of the drugs.Methods: This study was conducted in department of obstetrics and gynecology, NIMS Medical College, Jaipur, India during June 2017-August 2017. Total hundred cases were taken and divided into two groups. Group A was gestational age upto 49 days, Group B was gestational age 50-63 days. Both groups were given tab. mifepristone 200mg. followed by 48 hrs. by 4 tablets of tab misoprostol.Results: The results of the given regimen were highly successful and complete abortion was achieved in 96% and 94% in group A and group B respectively. The difference between two groups was statistically not significant (p value =0.64). Failure rates were seen in only 4% of group A and 6% of group B. Pain abdomen was seen in 16% of group A and 38% of group B patients. The difference between both groups was statistically significant (p value=0.02). Nausea was seen in 10% of group A and 30% of group B patients. The difference between both groups is statistically significant(p value=0.018).Conclusions: First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

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