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

Abstract

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.

Manual Vacuum Aspiration vs Vaginal Misoprostol for the Management of First-Trimester Incomplete Miscarriage in term of complete abortion

“…Miscarriage refers to the end of a pregnancy before the fetus reaches a viable stage 10 . First-trimester spontaneous miscarriages occur in approximately 11-15% of pregnancies.…”

Cephalosporins in pediatrics: Navigating antimicrobial resistance impact and adverse effects – A comprehensive review

“…1 Recurrent infections of the respiratory tract and gastrointestinal system are common in children. 3 Viral infections are estimated to account for 60% to 85% of all instances of acute infectious diarrhoea, including pathogens for which antibiotics may be prescribed (e.g., Campylobacter spp., Shigella spp., Escherichia coli, etc). 4 According to WHO standards, only 13.4-24.1% of antibiotics should be provided, yet studies show that parenteral antibiotic administration is far more common (83-85%) than oral antibiotic treatment (15%) in the paediatric population.…”

“…Beta-Lactam antibiotics were the most commonly administered and favoured antibiotics for combination treatment in paediatric patients. 3 It is a burden on our society that must be limited. For these compelling reasons, we have conducted a review on the pediatric use of cephalosporin, its resistance, emerging threats, and potential strategies to overcome it.…”

Antibiotics Prescription, Dispensing Practices and Antibiotic Resistance Pattern in Common Pathogens in Nepal: A Narrative Review

“…Studies on prescribing patterns are a part of medical audit that help to monitor, evaluate and suggest modification in prescribing practices. 11 Dispensing antibiotics without prescription remain common practice in Nepal and this inappropriate dispensing contribute to antimicrobial resistance. 12 Most commonly dispensed antibiotics in Nepal are cefixime, cefepodoxime, amoxicillin, azithromycin, ciprofloxacin, ofloxacin, cotrimoxazole, and metronidazole.…”