COMPARISON OF MIFEPRISTONE (200mg) FOLLOWED BY MISOPROSTOL (800µg) 6 HRS LATER WITH 24 HRS LATER IN EARLY PREGNANCY FAILURE

Abstract

INTRODUCTION: Early pregnancy failure (EPF) is an inclusive term that comprises incomplete, complete, or inevitable spontaneous abortion; anembryonic gestation (blighted ovum); and embryonic demise (missed abortion) at less than 14 weeks 1. It is one of the most common complications of pregnancy, accounting for approximately 15% to 20% of clinically recognized pregnancies 1,2. Many EPFs occur before pregnancies have been clinically recognized (that is, women mistake them for “late cycles”). AIMS & OBJECTIVES: To compare the efcacy between mifepristone 200mg orally followed by misoprostol 800µg vaginally 6 hrs later with mifepristone 200mg orally followed by misoprostol 800µg vaginally 24 hrs later in early pregnancy failure for termination up to 9 weeks of gestation. To reduce unusual blood loss. To reduce surgical intervention in case of early pregnancy failure. MATERIALS & METHODS: Hospital based Prospective randomiSe comparative single centre study. Department of Obstetrics and Gynecology Midnapore Medical College and Hospital. One year from January 2019 to February 2020 for data collection and six month for data analysis. Mother attended the Gynae OPD clinic and Obstetrics emergency with features of early pregnancy failure. The sample size was 50, with 25 patients in each group. RESULTS:We found that the table 4 shows the distribution according to gestational age. The main indication for which medical abortion was done in our study is early pregnancy failure (Blighted ovum) and missed abortion. Majority of patients were in the gestational age between 8-9 weeks with 48 % of women who underwent 6 hour interval regimen and 40% of women who underwent 24 hour interval regimen. P value documented is 0.849 which is not signicant. There was no signicant difference between two groups regarding gestational age (p value=0.849). SUMMARY AND CONCLUSION: Vaginal Misoprostol can be safely administered 6 hours following Mifepristone instead of waiting for 24 hours. Efcacy in achieving complete abortion rate is almost equal to 24 hours regimen and most acceptable from patient's side also. Additionally, women are less likely to experience side effects the earlier the misoprostol is used. Women can now have more exibility when using mifepristone and vaginal misoprostol for medical abortion