Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women

Shrivastava, Veena Rani

doi:10.3126/njog.v2i2.1456

Cited by 5 publications

(7 citation statements)

References 11 publications

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“…4 Pattern of side effects: Vaginal bleeding and uterine cramping (usually heavier than with menstruation) are expected. 10 In our study, women undergoing MTP experienced minimum 4 days and maximum 9 days of vaginal bleeding. None of the women reported heavy bleeding (Heavy bleeding: Two soaked maxipads in 1 hour for 2 consecutive hours 12 ), and none required a transfusion.…”

Section: Success Rate Of the Combination (Mifepristone And Misoprostomentioning

confidence: 68%

“…In her prospective study, Misoprostol was used vaginally and the success rate was 92.6%. 10 Kathleen et al, in 2011 performed a similar research with misoprstol administered vaginally, and the success rate was 80 %. 11 Recently, sublingual administration of Misoprostol has been studied for medical abortion and cervical priming.…”

Section: Success Rate Of the Combination (Mifepristone And Misoprostomentioning

confidence: 98%

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Use of Mifepristone and Misoprostol Combination on Abortion in First Trimester Pregnancy at Government Hospital in Chitwan District in Nepal

Thapaliya¹,

Thapa²

2015

Int. Res. J. Pharm.

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The present study is a prospective study and was aimed to identify the type and pattern of side effects during and after a medical abortion using a combination therapy of Mifepristone and Misoprostol, association between gestational age and success rate, and its efficacy. Assessment on acceptability, women's perceptions towards medical abortion, and reasons for abortion were also performed. The study was carried out in 500 beded government hospital in Chitwan district in Nepal. The women (n=85) with a gestational history of less than 59 days were enrolled. The regimen used was oral Mifepristone 200 mg followed by sublingual Misoprostol 800 mcg after 24 hours of Mifepristone administration. The women's profile form was used as a major data collection tool. Side effect sheet (typed in Nepali language for convenience) to be filled by the women undergoing medical termination of pregnancy (MTP) was issued, which was later submitted to us at the time of their follow-up visit. On follow-up, a pre-tested questionnaire was administered to determine perception and acceptability of MTP. The success rate was found to be 97.6%. Side effects recorded were vaginal bleeding, uterine cramping, abdominal pain, nausea, vomiting, headache, loss of appetite, and sleeplessness. There was a significant association between gestational age and success rate with P value of 0.003. The women provided different reasons for abortion and had a positive attitude towards MTP. In conclusion; the combination of oral Mifepristone and sublingual Misoprostol for medical abortion was found to be efficacious and sublingual administration of Misoprostol has a number of benefits over other routes (vaginal and oral) which could be further studied over a large population in future.

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Section: Success Rate Of the Combination (Mifepristone And Misoprostomentioning

confidence: 68%

Section: Success Rate Of the Combination (Mifepristone And Misoprostomentioning

confidence: 98%

Use of Mifepristone and Misoprostol Combination on Abortion in First Trimester Pregnancy at Government Hospital in Chitwan District in Nepal

Thapaliya¹,

Thapa²

2015

Int. Res. J. Pharm.

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“…In her prospective study misoprostol was used vaginally and the success rate was 92.6%. 11 Kathleen et al in 2011 performed a similar research with Misoprostol administered vaginally and the success rate was 80%.…”

Section: Discussionmentioning

confidence: 96%

“…9,10 This was because systemic bioavailability of misoprostol was 4 times higher through vaginal route when compared with oral route and peak level was attained more slowly but was sustained for longer periods. 11 The success rate of taking a 48 hour interval between the medications ranges from 92-97%. 2,12 Crenin et al reported success rate of 24 hour regimen to be 98.1% and 96.9% in their studies carried out in 2004 and 2007.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of evidence based regimen for medical abortion over conventional methods

Gopal

Ganamurali

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Medical abortion is a means of medical termination of pregnancy by drugs alone. This can be done upto 63 days using mifepristone and misoprostol tablets. For the conventional method, patient has to come to the hospital 3 times. In our study we reduced the interval between the drugs there by reducing the number of hospital visits. The objectives were to study the reduction of induction abortion interval following administration of evidence based regimen and to compare the proportion of patients developing complications in both the groups.Methods: It was a comparative study conducted at Department of Obstetrics and Gynecology, Govermnent MedicalCollege Kottayam, Kerala, India from May 2015 to November 2015.Results: The mean induction abortion interval in experimental group was 14.3 hours and in control group, it was 60.4 hours which was found to be statistically significant. Only 3 patients (7%) of experimental group had side effects whereas 12 patients. (17.4%) had side effects in the control group. Major side effects encountered were severe abdominal pain and severe bleeding per vaginum. Evidence based regimen consist of administration of mifepristone 200mg and vaginal misoprostol 600µg 6 hours later for termination of pregnancy up to 63 days could reduce the induction abortion interval by 46 hours and had less side effects.Conclusions: As it reduces the induction abortion Interval and complications we feel that the evidence based regimen for Medical Termination of Pregnancy is superior to the FDA approved regimen.

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“…5 Several studies have studied the vaginal use of misoprostol. 1,5,8 Our study evaluated the efficacy, side effects and acceptability of its sublingual use.…”

Section: Discussionmentioning

confidence: 99%

Safety, Efficacy and Acceptability of Early First Trimester Abortion using Oral Mifepristone and Sublingual Misoprostol

Shrestha

Aryal

Sharma

2018

J Nepal Health Res Council

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Background: With the legalization of medical abortion in Nepal, mifepristone-misoprostol combination via different routes has been widely used for early abortion. This study aims to evaluate the efficacy and acceptability of 200 milligrams mifepristone orally followed by 800 micrograms sublingual misoprostol in outpatient setting.Methods: It was an open-label prospective study conducted in outpatient department of a tertiary hospital over a period of 13 months. Clients upto nine weeks of pregnancy were enrolled. 200 milligrams of mifepristone orally followed by 800 micrograms of misoprostol sublingually 36 to 48 hours later were prescribed. They were followed up in 14 days sonologically or verbally through telephone. Side effects and satisfaction to the regimen were assessed through acceptability questionnaire. Mann-Whitney U test was used for analyzing categorical data.Results: A total of 47 clients were enrolled. The mean age and gestational age were 29.38 years (SD+5.914) and 6.2 weeks (SD+1.28) respectively. The commonest indications for termination were completed family and unwanted pregnancy (40.4% each). The average duration of bleeding was 5.76 days (SD +3.61). Abdominal cramping was the most common side effect (95.7%). The least acceptable parameter was the bleeding time (80.9%). For 97.9% clients, the adverse effects were acceptable. The overall success rate of the regimen was 87.2%.Conclusions: With a comparable success rate to vaginal use, home based sublingual use of misoprostol in low resource settings offers an acceptable and cost effective alternative for medical abortion upto nine weeks of pregnancy. Lesser gestational age is a useful predictor for successful abortion.

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Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women

Cited by 5 publications

References 11 publications

Use of Mifepristone and Misoprostol Combination on Abortion in First Trimester Pregnancy at Government Hospital in Chitwan District in Nepal

Use of Mifepristone and Misoprostol Combination on Abortion in First Trimester Pregnancy at Government Hospital in Chitwan District in Nepal

Effectiveness of evidence based regimen for medical abortion over conventional methods

Safety, Efficacy and Acceptability of Early First Trimester Abortion using Oral Mifepristone and Sublingual Misoprostol

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