Publication:

Second trimester termination of pregnancy with misoprostol alone and misoprostol with isosorbide mononitrate: a comparative study

Background Aim of the study was to compare the efficacy of misoprostol   alone and misoprostol with isosorbide mononitrate in reducing the induction abortion time interval in second trimester termination of pregnancy.

Methods A randomized control prospective study was conducted. Patients seeking second trimester abortions were randomized in to two groups. Group A received 400 ugm of misoprostol per vaginum every 4 hours up to maximum of 5 doses. Group B patients received 400 ugm of misoprostol and 40mg of isosorbide nitrate intravaginally. Repeat dose of 400 ugm misoprostol and 20 mg of isosorbide mononitrate was given every 4 hours up to a maximum of 5 doses. The induction to abortion interval and side effects of the drugs used were noted.

Results A total 71 women seeking second trimester termination between 12 to 20 weeks gestation were recruited for the study. In group A, there were 36 patients and in group B there were 35 patients. In group A the mean induction abortion interval was 14.8±4.16 hours while in group B the mean induction-abortion interval was 12.45±3.9 hours. Patients treated with isosorbide mononitrate and misoprostol combination had statistically significantly lower induction abortion time interval when compared with misoprostol alone (p value 0.018).

Conclusions The study demonstrates that the combination of isosorbide mononitrate and misoprostol is more effective for termination of second trimester pregnancy than misoprostol alone.