BACKGROUND: Though Mifepristone-Misoprostol combination is well established for early pregnancy termination, the optimal Misoprostol dose is still under much debate. AIMS: To compare the efficacy of sublingual 400µg Misoprostol and 800µg Misoprostol after oral 200mg Mifepristone in achieving complete abortion, to study the induction abortion interval, complications and adverse effects seen with both groups. Setting 100 antenatal women requesting for medical termination of pregnancy of upto 63 days of gestation in ESI Medical College and Postgraduate Institute of Medical Sciences and Research, Karnataka in India. Design A Prospective Observational study. METHODS AND MATERIAL: Study population was randomized into 2 groups of 50 patients each. Both groups received 200 mg Mifepristone. Twenty four hours later, Group A received 400µg sublingual Misoprostol and Group B received 800 µg sublingual Misoprostol. OUTCOME MEASURES: The primary outcome analyzed in this study is the efficacy of the two regimens in achieving complete abortion. Secondary outcome measures are Induction to Abortion interval and adverse effects like pain abdomen, nausea, vomiting, diarrhoea, fever and chills. STATISTICAL ANALYSIS USED: Averages and proportions were calculated for the study and appropriate statistical tests like Chi Square Test, Fischer Exact Test and Student T Test were done using MiniTab version 16. RESULTS: Administration of 400µg sublingual Misoprostol 24 hours after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. CONCLUSIONS: In the present study, administration of 400µg sublingual Misoprostol after 200 mg of Mifepristone has complete medical abortion rates comparable with 800µg sublingual Misoprostol with significantly lesser side effects. However further research with different doses and routes of administration of Misoprostol in required in a larger study population.
BACKGROUND India is a country where people are dependent on each other for psychological support. Traditional Indian culture follows a collectivist pattern where the woman cares more about her family and society than herself. An unmarried woman who is pregnant poses a problem for both herself and her baby here, where traditional values are held high and pregnancy without marriage is almost always a taboo. AIMS To find the impact of Termination of Pregnancy (TOP) on the anxiety and depression levels among pregnant women, correlation with period of gestation and the impact of perceived social support on anxiety and depression levels of these women. SETTING One hundred women who attended the outpatient department of ESICMC-PGIMSR, Bengaluru, India, requesting for Termination of Pregnancy, between August 2011 and December 2014 were studied. DESIGN A Prospective Observational study. METHODS AND MATERIAL Hospital Anxiety and Depression Scale (HADS) and Multidimensional Scale of Perceived Social Support (Zimet, 1988) were measured both pre-TOP and Hospital Anxiety and Depression Scale (HADS) was measured post TOP in women fulfilling the Inclusion and Exclusion criteria. STATISTICAL ANALYSIS Averages and proportions were calculated for the study and appropriate statistical tests like Wilcoxon Signed Ranks Test and Spearman's Correlation Coefficient were done using MiniTab version 16. RESULTS 1) There is a reduction of depression and anxiety after Termination of pregnancy (p <0.05) more so among unmarried women with an unwanted pregnancy. 2) The higher the period of gestation, the higher the levels of HADS anxiety levels were observed (p value of <0.05). 3) The lower the social support scores, the higher the levels of HADS anxiety and depression (p value of <0.05). CONCLUSIONS There is a need for larger number of abortion care providers in India with increased contraception awareness and education regarding the need for Termination of Pregnancy in medical professionals. Women undergoing termination of pregnancy, especially when recognized as having social issues like a pregnancy without a husband, should be provided with counseling for not only the women, but also the family to improve the mental status of the woman especially in a country with a collectivist culture like India.
Background: Antibiotics are increasingly being prescribed during pregnancy. Even though safe non-teratogenic drugs are prescribed, due to altered pharmacokinetics during pregnancy can have adverse effects on hepatic metabolism. Methods: This was a prospective analytical study conducted in the department of obstetrics and gynecology at ESIC Medical College and PGIMSR, Bengaluru, Bengaluru from August 2022 to January 2023, 62 pregnant women diagnosed with infection were admitted and evaluated for the effects of antibiotics on liver enzymes. All cases had undergone a baseline Liver function test before antibiotic therapy were compared and statistically analyzed with the liver enzymes, alanine transaminase (ALT), and aspartate transaminase (AST) values after 7 days of the antibiotic course. Results: In this study, the mean age of pregnant women enrolled was 26±3.62 years. Both primi (45.2%) and multigravida (54.8%) were equally represented. The most commonly prescribed antibiotic was cefotaxime (67.7%). The mean pre AST was 17.92±11.28 and post-AST was 18.34±15.55 U/l (paired t-test =0.861) and the mean pre-ALT was 13.09±19.82 and post-AST was 11.7±8.01 U/l (paired t-test =0.533). Hence there were no significant changes in post-AST and post-ALT compared to Pre AST and ALT values. Conclusions: In this study the common antibiotics administered were cephalosporins and they didn’t show any effects on AST or ALT values after completing the antibiotic course.
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