Abstract
Objectives: This study is to compare the efficacy of Mifepristone combined with Misoprostol (Prostaglandin) administered through vaginal and sublingual route in termination of pregnancy of ≤63 days. Methods: Randomized comparative study comprised of 140 pregnant women of ≤63 days gestational age was conducted at Zoram Medical College, Mizoram. Women in group A received 200 mg of Mifepristone orally on day 1 followed by 800 μg of Misoprostol sublingually 36–48 h later, whereas women in group B received 200 mg of Mifepristone orally on day 1 followed by 800 μg of Misoprostol vaginally 36–48 h later. A 2nd dose of 400 μg Misoprostol was given through the same route if abortion process does not start within 4 h. All women who aborted were seen at follow-up and ultrasound pelvis done to confirm complete expulsion of products of conceptions. Results: The total number of primigravida was 34 (24.3%) and multigravida was 106 (75.7%). Complete abortion was seen in 91.4% and 94.28% of per sublingual and per vaginal route group, respectively (p = 0.51). Failure of abortion was 8.57% and 5.71%, respectively, in per oral and per vaginal route (p = 0.51). Conclusion: Sublingual and per vaginal misoprostol after pre-treatment with mifepristone are both an effective method for termination of pregnancy for gestational age of 63 days or less, but the tolerance for sublingual misoprostol was poorer.
Highlights
Unsafe termination of pregnancy is the cause of substantial maternal mortality and morbidity worldwide
Various studies have shown that medical abortion with Mifepristone and Misoprostol is as effective when compared to surgical method
This study is conducted to compare the efficacy of Mifepristone combined with Misoprostol (Prostaglandin) administered through vaginal and sublingual route
Summary
Unsafe termination of pregnancy is the cause of substantial maternal mortality and morbidity worldwide. In the North Eastern state of Mizoram, a Christian dominated state, there is scarcity of willing healthcare providers to perform termination of pregnancy, due to religious belief and fear of social stigma and reprisals, and many women resort to over the counter drugs for medical termination of pregnancy without proper knowledge of the possible complications. Prostaglandins have been tried in the last three decades for termination of pregnancy up to 63 days. Various studies have shown that medical abortion with Mifepristone and Misoprostol is as effective when compared to surgical method. The current clinical protocols for medical termination of pregnancy require the combination of mifepristone (antiprogesterone) with Prostaglandins. This study is conducted to compare the efficacy of Mifepristone combined with Misoprostol (Prostaglandin) administered through vaginal and sublingual route
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