Publication:

A randomized study to compare the efficacy and side effects of misoprostol given either orally or vaginally for first trimester medical termination of pregnancy

Background Medical abortion represents an alternative to first trimester aspiration abortion and has been used by millions of women throughout the world. A numerous study has demonstrated that combination of mifepristone and misporostol is highly efficacious with success rate of approximately 97%.

Methods In the present randomized study 100 women who were requesting for first trimester medical abortion were included in the study. This randomized study was conducted for a period of one year in a tertiary health care centre. All these women were randomly assigned to receive either oral misoprostol (n=52) (group 1) or vaginal misoprostol (n=48) (group 2). We found that after the administration of mifepristone, vaginal misoprostol for the induction of abortion upto 49 days was more effective than oral misoprostol.

Results In present study maximum number of patients were in the age group of 26-30 years. Multiparous women comprised of maximum number of patients in both 70% in group 1 and 83% in group 2. The gestational age at the time of inclusion in study was maximum upto 7 weeks or 49 days gestation in both groups. Acceptability of medical abortion is more in urban locality i.e. 73% in group 1 and 81% in group 2. 73% in group 1 and 79% in group 2 chose to have misoprostol at home. 92% patients in group 1 and 95% patients in group 2 initiated bleeding per vaginum within 4 hours. Side effects like nausea, vomiting and diarrhea were compared. 92.4% patients in group 1 and 97% patients in group 2 who had expulsion of conception without need of surgical intervention was comparable. Only 2 patients in group 1 had incomplete abortion and needed surgical aspiration.

Conclusions This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.