Comparative Study of "Mifepristone with Vaginal Misoprostol" and "Vaginal Misoprostol Alone" in Second Trimester Medical Termination of Pregnancy

Abstract

Objective: The present study was conducted with the aim to assess and comparatively evaluate the safety and efficacy of misoprostol alone and mifepristone with misoprostol for second trimester termination of pregnancy.  

Methods and Materials: The study was conducted in 100 selected cases, divided in two groups of 50 cases each.  In the group A mifepristone 200 mg was given 48 hrs after which vaginal intravaginal insertion of 400ug of misoprostol upto a maximum of 5 doses or until the abortion occurs, whichever occurs early.  In the group B only, misoprostol was inserted in the same dose regimen. The results were analysed.

Results: The success rate is greater in mifepristone with misoprostol group with 98% than misoprostol group with 90% Mean induction abortion interval from the insertion of the first misoprostol tablet is significantly shorter in the mifepristone pretreated group 12.93+4.19 hr as compared to 19.18+3.97 hr in the misoprostol alone group (p<0.001).  The mean dose of the misoprostol required is significantly less in the mifepristone group as against misoprostol group (p=0.008). The side effects and complications observed in both the groups are mainly nausea vomiting, fever, abdominal cramps, bleeding, rigor, dizziness, retained products of consumption and these side effects are more in misoprostol group.

Conclusion:  Pretreatment with mifepristone 48 hrs before intravaginal misoprostol significantly improves the induction abortion interval with lesser side effects & complication.