Publication:

An observational study to evaluate the clinical outcomes and complications among women presenting with unsupervised MTP pill intake at a tertiary healthcare centre in South Gujarat

Background Unsupervised use of medical termination of pregnancy (MTP) pills is increasingly common in developing countries like India due to easy over-the-counter availability. Although safe under medical supervision, inappropriate use may lead to serious complications. Objectives of this study was to evaluate clinical outcomes and complications among women presenting with unsupervised MTP pill intake at a tertiary healthcare centre.

Methods This prospective observational study included 200 women who came with a history of unsupervised MTP pill intake at our hospital for one year, from March 2025 to March 2026, after obtaining official approval from the Institutional Ethical Committee. Data regarding demographic profile, gestational age, source of pills, clinical presentation, outcomes, complications, and treatment modalities were collected and analysed. Statistical associations were evaluated using appropriate tests, with p < 0.05 considered significant.

Results The majority of subjects were aged 21–25 years (38%), with a predominance of multigravida, rural (73%), and lower socioeconomic status (67%). Only 29% had prior ultrasound, while most obtained MTP pills from medical stores (60%). Half of the subjects (50%) consumed pills at 7–9 weeks, and most presented within 8–14 days (38%). The most common complaint was bleeding with passage of clots (48.5%). Incomplete abortion (63%) was the predominant outcome, followed by missed abortion (17%). Anaemia (55%) was the most common complication, with 17% requiring blood transfusion. Most subjects required intervention, with 62% undergoing dilatation and evacuation. Adverse outcomes were significantly associated with lack of prior ultrasound and higher gestational age.

Conclusions Unsupervised use of MTP pills is a significant public health concern leading to preventable complications. Easy over-the-counter availability promotes misuse without proper medical evaluation. Therefore, strict regulation of MTP pill distribution and dispensing only through authorized centers under medical supervision is essential.