Abstract
The aim: To study the efficacy and safety of combined mifepristone and misoprostol used in second-trimester abortion(≥ 12 and ≤ 20 weeks) in comparison with only vaginal misoprostol.
 Materials and methods: This study was a prospective comparative randomised clinical study in women attending hospitals in need of a second-trimester abortion, i.e., 12–20 weeks of pregnancy were taken up and divided as Group A – 50 women with mifeprisptone and misoprostol, Group B – 50 women with misoprostol alone Results were analysed according to age, parity, gestational age, average dose of misoprostol required for complete abortion, Induction abortion interval, completeness of abortion, side effects and mean days of hospital stay.
 Results: Demographic details are comparable and insignificant in the comparison. The average dose of misoprostol (mcg) required for the completeness of abortion in group A is 596±28.28 mcg, and in group B, it is 1148±160.66 mcg (p<0.001) which is statistically significant. In the present study, the induction abortion interval is significantly less in group A compared to group B, with p<0.001. In addition, 10 out of 50 patients in group A aborted within 7 hours, whereas none in group B. Mean duration of hospital stay in group A is 24 hours. In group B, it is 34.82 hours which is statistically significant with a p-value of <0.001. 12 patients in group A and 26 in group B had side effects like nausea, vomiting, fever, headache and diarrhoea. 8 % of group A and 20 % of group B had a fever. These patients were treated with antipyretics. 6 % in group A and 14 % in group B had nausea and vomiting and were treated with antiemetics. 4 % in group A and 8 % in group B had diarrhoea and were treated with antimotility drugs. 6 % in group A and 10 % in group B had a headache; these patients were treated with NSAIDs.
 Conclusions: The combination of mifepristone and misoprostol is a highly effective and safe method for second-trimester termination of pregnancy. The amount of misoprostol needed to accomplish the abortion, and the severity of the adverse effects are lower in the mifepristone-primed group than in the misoprostol-alone group. Since there are fewer difficulties, this approach can be employed in hospitals with high patient density.
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