A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy

Abstract

Objective To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14-20 weeks). Materials and methods The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women.Group-I received only misoprostol; 600 mcg initial vaginal insertion followed by 400 mcg sublingually every 3 h until termination. Women in Group-II received mifepristone 200 mg and after 24 h started with 600 mcg misoprostol, per vaginal followed by 400 mcg sublingually till abortion was completed, up to a maximum of five doses in both groups. Results The success rate in Group-I was 89 %, whereas in Group-II it was 96 %. The mean induction abortion interval in Group-I was 10.67 ± 3.96 h compared to Group-II which was significantly less 6.19 ± 2.70 h (p value \ 0.01). The mean dose of misoprostol in Group-I was 1610 ± 511.18 mcg and in Group-II, it was lesser 1046 ± 392.71 mcg (p value \ 0.01). There was significant difference in the mean blood loss also, 97.20 ± 36.35 ml in Group-I and 52.55 ± 27.96 ml in Group-II. Also among the individual groups multigravidae and lower gestational age (\17 weeks), women had lesser IAI as well as lesser misoprostol dose was required. 123Conclusion Pretreatment with mifepristone significantly reduces the induction abortion interval and the misoprostol dose along with minimal blood loss.

Study of the Efficacy and Success Rate of Single Dose Oral Mifepristone and Vaginal Misoprostol v/s Vaginal Misoprostol alone for Second Trimester Termination of Pregnancy

“…In a study conducted by Prasanna Lekha Akkenapally (2016) 3 , the mean dose of misoprostol required in group A was 1046mcg while that required in Group B was 1610mcg with a p value being less than 0.001 which was statistically significant.…”

“…In a study by Prasanna Latha Akkenapally 3 , the mean blood loss in group A was less (mean blood loss 52.55ml) as compared to Group B (mean blood loss 97.20ml).…”

“…In a study conducted by Prasanna Lekha Akkenapally (2016) 3 , the mean I-A-I was found to be 6.192.70 with a range of 8 to 13 hours 28 minutes in group A and 10.673.96 with a range of 4 hours 15 minutes to 7 hours 40 minutes.…”

“…It also ripens the cervix and has synergistic effect with misoprostol. Misoprostol (synthetic prostaglandin E1 analogue) binds to myometrial cells causing strong myometrial contractions leading to expulsion of fetus from the uterus 3 .…”

Comparison of Mifepristone plus Misoprostol with Misoprostol Alone for First Trimester Medical Abortion: A Systematic Review & Meta -Analysis Protocol

“…Original clinical trials [21,22] and reviews [23][24][25] showed that the combination regimen of mifepristone and misoprostol has resulted in higher proportion of success rate as compared to the misoprostol alone in second trimester abortions. On the other hand, a systematic review conducted to determine the effects of mifepristone during third trimester cervical ripening concluded to have inadequate evidence for suggesting the drug for labour induction [26].…”