scholarly journals Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women

1970 ◽  
Vol 2 (2) ◽  
pp. 54-58 ◽  
Author(s):  
Veena Shrivastava

Unsafe abortion is a major health issue. Therefore safe abortion services which is effective. acceptable and techniquely easy to perform should be available. Aim- To confirm effectiveness, side effects, safety and patient satisfaction with medical termination of early pregnancy. Methods- It was a prospective study 150 women who were less than 63 days pregnant and consented for medical termination of pregnancy were given! 200mg 0 Mefepristone orally and 48 hrs later 800 micro gram Misoprostol was inserted vaginally. They were followed up in 14 days. Bleeding, pain G.I symptoms any other side effects were recorded. Abortion was complete or not was confirmed clinically and by USG. Failure and success was documented depending upon need for surgical evacuation. Results- The success rate with this regime was 92.6% and failure rate was 7.3%. There were no major side effects with Mifepristone. The average bleeding after misoprostol insertion was 10 days and 80% women had more bleeding than normal period. All of them had pain. Only 13.3% needed analgesic. women (96%) were satisfied with the method. Conclusion- combination of mifepristone and misoprostol is a safe and effective of early pregnancy Keywords- medical termination, pregnancy, mifepristone, misoprostol.   doi:10.3126/njog.v2i2.1456 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 54 - 58

1970 ◽  
Vol 7 (3) ◽  
pp. 209-212 ◽  
Author(s):  
N Chuni ◽  
TS Chandrashekhar

Background: An estimated 30 million abortions are performed worldwide every year. Many women do not have access to abortion and die of complications after illegal abortions. Medical abortion could provide greater access to safe abortion services; availability of the procedure is, therefore, of global public health importance. Aim: The aim was to study the efficacy of lowered dose of Mifepristone in medical abortion. Materials and methods: One hundred and twelve cases with a pregnancy of 63 days duration or less were enrolled in a prospective study using a lowered dose of 200mg Mifepristone followed, 48 hours later, by home administration of 400μg Misoprostol orally. At the second visit, on day 15, outcome and adverse effects were analysed. Women who failed to undergo a complete abortion were further managed by surgical evacuation of uterus. Results: The mean gestational age was 50.6 days. The rates of complete abortion were 92.8%, 83 % and 80 % in the ≤49 days group, 50 to 56 days and 57 to 63 days group respectively. Vaginal bleeding emerged as the biggest reason for medically indicated termination. Nulliparous women had a greater frequency of side effects, though values did not reach statistical signifi cance. Conclusion: This regimen of a lower dose of 200mg Mifepristone, followed by home administration of 400μg oral Misoprostol 48 hours later is safe and highly effective especially in pregnancies of up to 49 days duration. Key words: Mifepristone; Medical termination of pregnancy (MTP) DOI: 10.3126/kumj.v7i3.2725 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 209-212


2017 ◽  
pp. 20-25
Author(s):  
S. V. Apresyan ◽  
V. I. Dimitrova ◽  
O. A. Slyusareva

The article describes the specific features of termination of progressive uterine pregnancy in the II trimester. It was found that the efficacy of medical abortion in the II trimester of pregnancy is 94–98%. High efficacy, low incidence of side effects or early and late complications and economic feasibility demonstrate that the method is promising and safe; therefore, it can be recommended as a priority when choosing a method for medical termination of pregnancy in the II trimester.


Author(s):  
Anitha K. Gopal ◽  
Sajini B. Sajini B. ◽  
Ganamurali S. ◽  
Beena Kumari R.

Background: Medical abortion is a means of medical termination of pregnancy by drugs alone. This can be done upto 63 days using mifepristone and misoprostol tablets. For the conventional method, patient has to come to the hospital 3 times. In our study we reduced the interval between the drugs there by reducing the number of hospital visits. The objectives were to study the reduction of induction abortion interval following administration of evidence based regimen and to compare the proportion of patients developing complications in both the groups.Methods: It was a comparative study conducted at Department of Obstetrics and Gynecology, Govermnent MedicalCollege Kottayam, Kerala, India from May 2015 to November 2015.Results: The mean induction abortion interval in experimental group was 14.3 hours and in control group, it was 60.4 hours which was found to be statistically significant. Only 3 patients (7%) of experimental group had side effects whereas 12 patients. (17.4%) had side effects in the control group. Major side effects encountered were severe abdominal pain and severe bleeding per vaginum. Evidence based  regimen consist of administration of mifepristone 200mg and vaginal misoprostol 600µg 6 hours later for termination of pregnancy up to 63 days could reduce the induction abortion interval by 46 hours and had less side effects.Conclusions: As it reduces the induction abortion Interval and complications we feel that the evidence based regimen for Medical Termination of Pregnancy is superior to the FDA approved regimen.


Author(s):  
Parul S. Jani

Background: MTP has been legalized in India since 1971. MTP pill (Medical abortion) refers for early pregnancy termination (usually before 9 week gestation) performed without any primary surgical interventions. This study was called out to measure its effectiveness and safety as an abortificiant drug.Methods: This is a prospective study of 57 cases, conducted at OBSTETRIC and GYNECOLOGY Department, GMERS Medical College, Dharpur, Patan (N.G.) from April 2017 to April 2018.Results: In present study,61.4% women are of 20-30 years of age. Majority of women are (82.5%) of 2nd and 3rd para. Complete abortion was found in 91.2%. Incomplete abortion was in 7%. And there was no effect in 1.8%. Major side effects were bleeding (84.2%), abdominal pain (85.9%). Misoprostol related side effects are minimal.Conclusions: The present observational study demonstrates that mifepristone and misoprostol combined therapy is an effective and well tolerated medication in Indian adult women (≥18 years) requiring medical termination of intrauterine pregnancy (MTP) up to 63 days’ gestation.


Contraception ◽  
2012 ◽  
Vol 85 (4) ◽  
pp. 398-401 ◽  
Author(s):  
Kamal Ojha ◽  
David J. Gillott ◽  
Patricia Wood ◽  
Elizabeth Valcarcel ◽  
Arti Matah ◽  
...  

Author(s):  
Shikha Seth ◽  
Arun Nagrath ◽  
Neeru Goel

Background: Abortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100 mg) of Mifepristone (PO) instead of the presently recommended 200 mg for medical abortion in early first trimester cases. Objectives: The objective of the study was to determine the efficacy of low dose (100 mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800 μg, 24 hours later.Design: A prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions.Method: Pregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100 mg Mifepristone orally on Day-1, followed by 800 μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours. Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention.Results: The total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours.Conclusion: Mifepristone 100 mg, followed 24 hours later by Misoprostol 800 μg orally, is a safe and effective regimen for medical abortion.


2021 ◽  
Vol 104 (10) ◽  
pp. 1626-1631

Objective: To compare the complete abortion rate, the induction-to-abortion time, and side effects between 600 mcg and 800 mcg misoprostol sublingually. Materials and Methods: Total, of 108 pregnant women with gestational age less than 12 weeks with early pregnancy loss from March 2020 to February 2021 at the Department of Obstetrics and Gynecology, Queen Savang Vadhana Memorial Hospital, were included. For group 1 (n=54), 600 mcg misoprostol was administrated sublingually. For group 2 (n=54), 800 mcg misoprostol was administrated sublingually. If the abortion did not occur, the repeated misoprostol in the same dose would be administrated sublingually every 6 hours for a maximum of three doses. Results: There was no significant difference in the complete abortion rate between the two groups (55.6% in the 600 mcg misoprostol group, 64.7% in the 800 mcg misoprostol group, p=0.339, and 95% CI 0.082 to 1.862). The induction-to-abortion time was 9.5 hours (IQR 6.75 to 48.00) in the 600 mcg misoprostol group and 10 hours (IQR 6.00 to 60.00) in the 800 mcg misoprostol group. The side effects of both groups were similar, included abdominal pain, diarrhea, nausea and vomiting, fever, heavy bleeding, and headache. Conclusion: The efficacy of the 600 mcg misoprostol was noninferior to 800 mcg misoprostol. The adverse effects were similar in both groups. Mean induction-to-abortion time was also similar in both groups. Keywords: Early pregnancy loss; Misoprostol; Medical abortion


2019 ◽  
Vol 45 (3) ◽  
pp. 177-182
Author(s):  
Ingrida Platais ◽  
Tamar Tsereteli ◽  
Galyna Maystruk ◽  
Dilfuza Kurbanbekova ◽  
Beverly Winikoff

IntroductionWe aimed to assess the feasibility and acceptability of a second-trimester medical abortion regimen using mifepristone and sublingual misoprostol with no maximum number of misoprostol doses in Uzbekistan and Ukraine.MethodsThis prospective open-label study enrolled 306 women with pregnancies of 13–22 weeks in Uzbekistan (n=134) and Ukraine (n=172). Women took 200 mg mifepristone at a place of their choosing, and 24–48 hours later received 400 μg sublingual misoprostol every 3 hours until the expulsion of both fetus and placenta. Study staff interviewed women about the intensity of pain, side effects, and satisfaction with the procedure. The primary outcome was the rate of complete uterine evacuation without surgical intervention or oxytocin at 15 hours after the first dose of misoprostol.ResultsThe median gestational age was 18.1 weeks, and half of the women (n=149, 48.9%) chose to take mifepristone at home. The majority of women (n=266, 86.9%, 95% CI 82.6% to 90.5%) expelled by 15 hours after the start of misoprostol treatment, and by 48 hours complete uterine evacuation was achieved in 296 (96.7%) women. Most women found pain (76.1%) and side effects (89.0%) to be acceptable or very acceptable, and reported high satisfaction (89.8%) with the procedure.ConclusionMedical abortion in pregnancies of 13–22 weeks with 200 mg mifepristone followed 24–48 hours later by 400 μg sublingual misoprostol administered every 3 hours until complete expulsion is effective, safe and acceptable to women. Women can be given the option to take mifepristone at home and return to the hospital.Clinical trials registration numberClinicalTrials.gov, www.clinicaltrials.gov, NCT02415894, NCT02235155.


2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  

Abstract Background: Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results: We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children. Conclusion: This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.


1970 ◽  
Vol 7 (2) ◽  
pp. 127-130 ◽  
Author(s):  
V Shrivastava ◽  
A Shrivastava

Background: Combined mifepristone and misoprostol is the best method of medical termination of pregnancy. The study is undertaken to find out the success rate, acceptability, efficacy and patient satisfaction of medical abortion in pregnant women with 49 days of gestation. Methods: The pregnant women with amenorrhea of 49 days or less seeking termination of pregnancy received were studied. The 200 mg of oral mifepristone and followed 48 hours later with 600 microgram of oral misoprostol were given. Results: The success rate with the regime was 47 (94%) and 49 (98%) were satisfied. Weakness 24 (48%), Nausea 10 (20%), diarrhea 12 (25%), needing analgesic 4 (8%) were the side effects of the combined regime. Conclusions: Medical termination of pregnancy with combination of mifepristone and oral misoprostol has a good success rate. The side effect of the regimen in our setup is less and well accepted. Majority of the patient are satisfied with medical termination of pregnancy. Key words: medical abortion; misoprostol; mifepristone DOI: 10.3126/jnhrc.v7i2.3021 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 127-130


Sign in / Sign up

Export Citation Format

Share Document