Comparative study of mifepristone plus vaginal misoprostol versus vaginal misoprostol for second trimester (13-20 weeks) abortion at a tertiary care centre in Western India

Abstract

Aims: To compare the abortifacient efficacy of vaginal misoprostol with mifepristone (mife+miso) and vaginal misoprostol alone (miso) in second trimester (13-20 weeks) pregnancy termination. To compare the induction-abortion intervals, side effects and complications in both groups. To eventually identify the suitable method for second trimester (13-20 weeks) abortion by comparing the various parameters. Methodology: This prospective randomized comparative study was conducted to compare the efficacy of mifepristone +misoprostol combination with misoprostol alone as a method of second trimester abortion who presented at our tertiary care centre in western India, over a period of one and a half year. Results: Mean age distribution was similar in both groups, with majority of patients between 21-25 years of age. 52% of patients of mife+miso group and 50% of patients of miso group were gravida three and above. Most of the pregnancies were terminated in 17-20 weeks of gestation in both groups. Maximum of the patients in both study groups belonged to anomalous group followed by missed abortion group. In my study, a significant difference was found in induction-abortion interval in both groups. It was significantly lower in mifepristone + misoprostol Group with a p value of <0.0001. Dose required to terminate second trimester pregnancy along with number of repeat doses required was statistically significantly lower in mifepristone + misoprostol group than miso group. The most common side effect among both the groups was diarrhoea followed by nausea. Outcomes were almost complete in both the groups. The number of successful abortions in Mifepristone + Misoprostol group was 100% and that in misoprostol group was 98%. Conclusion: In our study it was observed that Mifepristone +misoprostol combination group is associated with shorter induction abortion interval and >95% success rate. The complete abortion rate, success rate and side effects were comparable in both groups. Vaginal misoprostol alone group can also be considered as an effective alternative for Mife+miso combination group.