Low Dose Mifepristone And Vaginal Misoprostol: A Safe Option For Termination Of Pregnancy Up To 63 Days

Abstract

Aim: To evaluate the efficacy and safety of low dose mifepristone (200mg) followed 48 hours later by 400µg of vaginal misoprostol to terminate pregnancy up to 63 days Methods: This was a prospective study enrolling 72 healthy women, 37 with less than 49 days gestation (group A) and 35 with 50 to 63 days gestation (group B). They were given 200 mg of mifepristone orally followed by 400µg of misoprostol vaginally after 48 hours. Failure was defined as need for surgical intervention for any reason. Secondary outcome measures were side effects, complications and acceptability. Results were compared between the two groups. Results: Both the groups were comparable with respect to age, parity and hemoglobin. Complete abortion occurred in 97.3% in <49days pregnancy group and 97.1% in 50 -63 days group. In 19.4% subjects, bleeding started following mifepristone alone and in rest it started within 4 hrs of receiving misoprostol and lasted for 11.5 days. Mean duration of bleeding was longer in group B (13.15 vs. 9.97 days). Mean fall in hemoglobin was minimal (0.42 gm%) though it was more in group B (0.49gm%) than in group A (0.37gm%). Moderate amount of pain was reported by 71.4% and 37.8% subjects in group B and A respectively. Analgesics were required by 13.9% of subjects. Incidence of nausea, vomiting and diarrhea was 26.4%, 9.7% and 15.3% respectively and it was similar in either groups. Conclusion: Medical abortion using low dose mifepristone and vaginal misoprostol is a safe and effective option for terminating pregnancy up to 9 weeks.