Clinical observation of first trimester abortion induced by mifepristone and misoprostol in pregnant women in terms of success, side effects and acceptability

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.

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Comparative evaluation of two commonly administered regimens of mifepristone and misoprostol for first trimester abortion

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182877 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2759

Author(s):

L. Thulasi Devi ◽

Ravi Nimonkar

Keyword(s):

Side Effects ◽

Tertiary Care Hospital ◽

Randomized Study ◽

Tertiary Care ◽

First Trimester ◽

Family Welfare ◽

Care Hospital ◽

Trimester Abortion ◽

Misoprostol Group

Background: The objective of this study was to compare and evaluate the efficacy of two commonly administered regimens as per existing guidelines of Ministry of Health and Family Welfare for Outpatient MTP services. This study is aimed at evaluation of subjective and objective stastical benefits and side effects in performance of first trimester abortion on OPD basis in popularly used drugs as advised by MOHFW by different routes of administration. The drugs used were Tab Mifepristone (RU – 486) and Tab Misoprostol.Methods: This prospective randomized study was conducted in Out Patient Department of Obstetrics and Gynaecology in a tertiary care hospital over a period of 1 year after due clearance was obtained from Ethical Committee. This was prospective study involving 400 ladies reporting for Outpatient MTP services within the given time period as per existing guidelines at a tertiary care hospital. Patients were assessed at the end of 7, 15and 56 days, the mean age of the patients was 24.5±0.5 and 33±1 years and treatment duration was an average of 3 days with follow up for 15 days post administration. Few cases of failure required a follow up of approximately 56 days. All patients were on follow up for a period of 3 months for determination of menstrual irregularities and contraception management.Results: Between the 2 groups, in the sublingual Misoprostol group 100% aborted successfully at the end of 56 days. Whereas in the vaginal Misoprostol group 99% aborted successfully at the end of 56 days, only two patients requiring MVA as an OPD procedure.Conclusions: Patients were assessed at the end of 7, 15 and 56 days and between both the groups; Mifepristone with administration of misoprostol sublingually showed better success rate in completion of procedure, quicker action with better patient satisfaction and acceptance compared to conventional administration of Mifepristone and vaginal administration of misoprostol. Misoprostol administered sublingually under medical supervision is a superior, faster abortificient and has lesser incidence of Retained Products of Conception (RPOC) or need for Suction & Evacuation (S&E) as compared to vaginal route. Side effects observed need more evaluation with larger sample size to be statistically significant.

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Does Prolactin Influence First Trimester Abortion? A Preliminary Clinical Observation

Gynecologic and Obstetric Investigation ◽

10.1159/000299432 ◽

1983 ◽

Vol 15 (6) ◽

pp. 362-364

Author(s):

E. Peer ◽

B.A. Peretz ◽

E. Paldi

Keyword(s):

Clinical Observation ◽

First Trimester ◽

Trimester Abortion

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Maternal and perinatal outcomes in women with first trimester vaginal bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194850 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4320

Author(s):

K. Suganya ◽

Latha Maheswari Subbarayan

Keyword(s):

Pregnant Women ◽

Vaginal Bleeding ◽

Case Control Study ◽

Preterm Labour ◽

Perinatal Outcomes ◽

First Trimester ◽

Case Control ◽

Second Trimester ◽

Trimester Abortion ◽

Control Study

Background: First trimester bleeding is one of the common complications during pregnancy which affects almost 16-25% of all pregnancies. To evaluate and ascertain the adverse maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding.Methods: Prospective case-control study. A case control study involving 60 pregnant women with vaginal bleeding in the first 13 weeks + 6 days of gestational age with 60 matched controls. The study period was from March 2015 to March 2016 and conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu.Results: The complications seen in the study group were: first trimester abortion (16.7%), second trimester abortion (6.7%), preterm labour (25%), abruption (6.7%), neonatal intensive care admission (25%), ectopic (6.7%), IUGR (10%), IUD (1.7%) and PROM (8.3%). When compared with the parity matched controls there was statistically significant increase in first and second trimester abortions, preterm labour, abruption, NICU admission and ectopic pregnancy whereas there was no significant difference between the two groups with regard to intrauterine growth restriction (IUGR) and intrauterine death (IUD).Conclusions: Women with first trimester vaginal bleeding had several adverse outcomes in both the mother and the fetus, and it is very important to explain about the possibility of these outcomes and ensure proper follow up with close antenatal surveillance.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172354 ◽

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.

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Comparison of Mifepristone plus Misoprostol with Misoprostol Alone for First Trimester Medical Abortion: A Systematic Review & Meta -Analysis Protocol

10.21203/rs.2.19280/v1 ◽

2019 ◽

Author(s):

Tariku Shimels ◽

Mebratu Abraha ◽

Mensur Shafie ◽

Lemi Belay ◽

Melsew Getnet

Keyword(s):

Systematic Review ◽

Side Effects ◽

English Language ◽

Meta Analysis ◽

Medical Abortion ◽

First Trimester ◽

Clinical Trial Registry ◽

Trimester Abortion ◽

Registration Number ◽

Randomized Control

Abstract Background Original clinical trials have demonstrated that the combined mifepristone plus misoprostol has a marked effectiveness on first trimester abortion practices compared to the misoprostol alone regimen. However, there is no clear evidence if this effect holds consistent direction for all main outcomes and, whether subsequent complications or side effects are minimal or not. This review is intended to provide aggregated evidence for this question through comparison of the respective regimens based on findings from previous randomized control trial studies. Methods Randomized control trials which compared mifepristone plus misoprostol with misoprostol alone for first trimester medical abortion and published in English language will be included in the review. Articles attempted to evaluate procedures and mechanisms of first trimester abortion other than mifepristone plus misoprostol combined regimen with misoprostol alone will be excluded. An internet based search of different engines will be undertaken to identify articles on the proposed topic. Using text words contained in the titles and abstracts of relevant articles, a full search of PubMed/Medline, Cochrane CENTRAL, EMBASE, WHO international clinical Trial registry platform and google scholar will be made. Data on participants, study methods, interventions, and outcomes will be abstracted. Included studies will be pooled for meta-analysis. Results will be reported in odds or risk ratio at 95% confidence interval. Discussion This systematic review intends to review the available literature on effectiveness of mifepristone plus misoprostol as compared to misoprostol alone for inducing abortion in the first trimester of pregnancy. In addition, we anticipate that the review will evaluate and compare the incidence of potential complications and side effects following administration of the respective regimen in both populations. Systematic review registration number CRD42019134213

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Comparative study of efficiency of vaginal versus oral misoprostol along with mifepristone for first trimester medical termination of pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192424 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2322

Author(s):

Latika R. Mehta ◽

Grishma P. Agrawal

Keyword(s):

Side Effects ◽

Tertiary Care ◽

First Trimester ◽

Termination Of Pregnancy ◽

Trimester Abortion ◽

Drug Effectiveness ◽

Oral Misoprostol ◽

Oral Group ◽

Vaginal Misoprostol ◽

Set Up

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.

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Clinical case of periostitis in pregnant women complicated by sepsis

Medical alphabet ◽

10.33667/2078-5631-2020-16-61-63 ◽

2020 ◽

pp. 61-63

Author(s):

S. Sh. Kakvaeva ◽

M. A. Magomedova ◽

A. N. Dzhalilova

Keyword(s):

Pregnant Woman ◽

Multiple Organ Failure ◽

Pregnant Women ◽

Organ Failure ◽

Clinical Case ◽

Clinical Observation ◽

Infectious Agent ◽

Modern Medicine ◽

Multiple Organ ◽

Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

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Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.160 ◽

2016 ◽

pp. 160-164

Author(s):

D.N. Maslo ◽

Keyword(s):

Pregnant Women ◽

Resistance Index ◽

First Trimester ◽

Reproductive Technologies ◽

Premature Delivery ◽

Control Group ◽

Uterine Arteries ◽

Placental Dysfunction ◽

Placental Blood ◽

Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

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