Publication:

A prospective observational study of clinical profile, management modalities and outcomes in women undergoing second trimester induced abortions at a tertiary care centre in South Gujarat

Background Second trimester abortion is associated with significantly higher maternal morbidity compared to first trimester termination despite accounting for a smaller proportion of induced abortions. Delayed diagnosis of fetal anomalies, limited access to healthcare services, and socioeconomic barriers continue to contribute to second trimester terminations in developing countries. Aim was to evaluate the clinical profile, management modalities, and outcomes of women undergoing second trimester induced abortion at a tertiary care centre.

Methods This prospective observational study was conducted in the department of obstetrics and gynecology at a tertiary care teaching hospital in South Gujarat over a period of 12 months. Fifty women undergoing second trimester medical termination of pregnancy between 13 and 24 weeks of gestation were enrolled. All participants received mifepristone 200 mg orally followed by vaginal misoprostol 400 µg every 6 hours after 24-48 hours. Clinical profile, indications for termination, induction-abortion interval, success rates, and complications were analysed.

Results Most participants were multigravida women belonging to rural and lower socioeconomic backgrounds. Fetal anomalies were the most common indication for termination (46%), followed by maternal medical indications (42%). The majority of patients required two to three doses of misoprostol, and 78% achieved abortion within 24 hours of induction. Complete abortion was achieved in 88% of cases. Retained products of conception were observed in 10% of patients, while major complications such as haemorrhage, uterine rupture, or infection were not encountered.

Conclusions Medical termination using the mifepristone-misoprostol regimen is a safe, effective, and reliable method for second trimester induced abortions when performed under appropriate clinical supervision.