Publication:

A randomised controlled trial to compare the efficacy of preinduction with mifepristone 12 hours versus 24 hours prior for second trimister pregnancy termination

Background Since the second trimester termination of pregnancy is on rise due to the detection of anomalies, this study aims to provide a safe regimen with respect to efficacy, side effects and acceptability for second trimester pregnancy termination.

Methods It is a randomized controlled trial, conducted on 48 cases at BLDE Medical college, Vijayapur, Karnataka. They were divided into two groups; all patients were given mifepristone 200mg orally followed by misoprostol 400mcg vaginally after 12 hours in group I and 24 hours in group II respectively. Subsequent doses were decided depending on the Bishops score. Results were analyzed in terms of induction-abortion interval and dosage of misoprostol.

Results The mean induction abortion interval was 563.9 minutes (9.3hrs) in group I and 714.6 minutes (11.9hrs) in group II; but was statistically not significant (p value 0.611) The total dose of misoprostol used was 783.3mcg in group I compared to 550mcg in group II, but was statistically not significant. The success rate was 100% in both the groups as none of them had incomplete abortion. There were no cases of uterine rupture, infection, need for check curettage and laparotomy.

Conclusions Our study proves that the interval between mifepristone and misoprostol can be safely reduced to 12 hours without affecting the efficacy. But in gestational age <16 weeks and primigravida 24 hours interval may be of benefit. Both the regimens were 100% successful.