Effect of Lowering the Dose of Misoprostol for Second Trimester Termination of Pregnancy Along With Mifepristone

Abstract

BACKGROUND In India, second trimester termination is reportedly performed in about 11-14% of women. However, abortion is grossly underreported in the official data. A large number of termination of pregnancies is done by unaccredited centres due to various reasons and thus it is extremely important to ensure the safety of the regimen when used in a low-resource setting. So, we conducted a study to determine if lowering the dose of misoprostol significantly compromises the efficacy of second trimester abortion regimens. Aims and Objectives-To study if decreasing the dose of misoprostol used for second trimester termination of pregnancy significantly alters the efficacy of the regimen and also if it is more acceptable in terms of complications and side effects. MATERIALS AND METHODS 100 women seeking termination of pregnancy between 12-20 weeks of gestation were randomised into two equal groups using computerised random number tables. Women were given Tab. Mifepristone 200 mg orally followed by 36 hours and later by Tab. Misoprostol 400 mcg or 200 mcg vaginally 3 hourly for a maximum of 5 doses in Group R1 and R2 respectively. Comparison was done using stringent and non-stringent criteria depending on whether a check curettage was required or not. Statistical analysis was done using Chi-square/ Fisher's exact test for qualitative variables and student's 't' test for quantitative variables. Settings and Design-A prospective randomised comparative study at a District Hospital. RESULTS The two groups were comparable in terms of age, parity and gravidity. Success rate at the end of 72 hours was 82% and 88% in Group R1 and R2 respectively using stringent criteria and 98% and 96% using non-stringent criteria. Mean induction abortion interval was 42.89 (± 9.66) in R1 and 43.09 (± 8.62) in R2 using stringent criteria. We found that regimens are comparable in terms of safety, success, induction-abortion interval and side effects.