Mortality and morbidity associated with illegal use of abortion pill: a prospective study in tertiary care center

Self administered medical abortion pills: evaluation of the clinical outcome and complications among women presenting with unsupervised pill intake to a tertiary care hospital in Malwa region of Punjab, India

“…These results were seen to be similar to studies by Mishra et al (78%), Giri et al (83%), Thaker et al (89.1%) and Kumari et al (86.67%). [3][4][5][6] As per MTP Act of India, the safe upper gestational age limit for pill intake is upto seven weeks. The risk of complications associated with all forms of abortion increases with gestational age, rising exponentially after first trimester even if performed under the best circumstances.…”

“…These results are similar to studies by Agarwal M et al (73%) (7) and also by Kumari R et al (70% ). 6 Hence this depicts the true scenario, that despite legal ban on over the counter supply of this drug and strict guidelines of MTP Act, the drug is being widely misused .The main reason cited by the patients for avoiding authorised medical centres as first approach to treatment was easy over the counter pill availablilty in 58% cases as it meant a quick solution to their problem than to indulge into more cumbersome procedures at authorised centres.. The most frequent complaint for admission was heavy vaginal bleeding along with history of passage of fleshy mass, suggesting incomplete abortion in 49% patients.…”

“…This is similar to studies by Kumari R et al and by Mishra N et al where surgical curettage was required in 50% and 46.5% of the cases respectively. 6,3 In medical abortion practice, method failure is said to occur when due to any reason a woman needs surgical evacuation to complete the abortion. Nearly 2-10% of women who otherwise choose supervised medical abortion would end up in surgical evacuation.…”

“…These results were similar to another study by Kumari R et al where 23.3% women had severe anaemia requiring blood transfusions. 6 More than half (52%), had mild to moderate anaemia which necessitated oral or intravenous iron therapy. Nearly a quarter of patients (24%) presented with life threatening shock requiring urgent resuscitation, accounting for near miss mortality cases in our study.…”

“…Ideally any method of medical abortion should have ongoing pregnancy rate of less than 1% but in our study continuation of pregnancy to late first trimester and mid-trimester was reported in 13% women. 6 The high incidence of continued pregnancy strongly points out to erroneous and incomplete dosing schedules with which the drug is prescribed by the unauthorised personnel. Serious life-threatening complications like sepsis are common in women undergoing unsafe abortions.…”