Abstract
Abstract Background Combined mifepristone and misoprostol has been used as an effective method of second trimester pregnancy termination in developed countries. But little is known about its use and effectiveness in developing countries. Objectives To assess the effectiveness of mifepristone and Misoprostol in second trimester termination of pregnancy among women admitted to a teaching hospital in Ethiopia. Methods A cross-sectional study was conducted was conducted using a structured questionnaire to collect data clinical profile of patients, the total dose of misoprostol used, the timing of expulsion and complications. The protocol used was: Mifepristone 200 mg oral and 400 mcg misoprostol for gestational age of 13 to 24 weeks and 100 mcg for 24 to 27 + 6 weeks of gestation given intra-vaginally every 3 hours until a maximum of 10 doses in 48 h. Data was entered and analyzed using SPSS. Results In this study 102 patients with 2nd trimester pregnancy between gestational age of 14 to 27 wks + 6 days were given a combined Mifepristone and Misoprostol. About 98 (81.7%) cases have expelled the fetus within 24 hrs. whereas 111 (92.5%) of the cases expelled within 48 hrs of the initiation of medical termination. In 79 cases (77.5%), fetal expulsion has occurred with the first course of misoprostol and about 91 cases (89.2%) have completed the expulsion with the second course of the treatment. There were no cases of uterine rupture and bleeding necessitating blood transfusion. Conclusion Mifepristone and misoprostol combination use for second trimester termination of pregnancy is safe, effective and is not associated with significant complications.
Highlights
Abortion can be spontaneous or induced and there are various methods of effecting evacuation of products of conception [1,2,3]
Medical abortion became an alternative method of abortion with the availability of prostaglandin analogs in the 1970s and the anti-progestogen mifepristone in the 1980s [4,5]
Misoprostol, a prostaglandin E1 analogue has gained a wide popularity in obstetrics; it can be used for cervical ripening and labor induction at term, for treatment of postpartum hemorrhage, and for first and second trimester abortions [3,4]
Summary
Abortion can be spontaneous or induced and there are various methods of effecting evacuation of products of conception [1,2,3]. Modern methods use medication or surgery for abortions [4] Medical abortions are those induced by abortifacient pharmaceuticals. Medical abortion became an alternative method of abortion with the availability of prostaglandin analogs in the 1970s and the anti-progestogen mifepristone ( known as RU-486) in the 1980s [4,5]. Both medication abortion and surgical abortion are safe and effective in the second trimester, the choice of which may depend on patient and clinical characteristics or expertise of the [1,2].
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