Clinical Study

Is mifepristone needed for second trimester termination of pregnancy

  • Nupur Gupta
  • Suneeta Mittal

Received Date: 24.11.2006 Accepted Date: 31.01.2007 J Turk Ger Gynecol Assoc 2007;8(1):58-62

OBJECTIVES

To assess the safety, efficacy and induction abortion interval of combination of mifepristone/ misoprostol for termination of pregnancy in the second trimester between 13 to 20 weeks gestation.

MATERIAL-METHODS

We performed a retrospective analysis of prospectively collected data among 70 healthy pregnant women aged 16 to 40 years, requesting second trimester termination of pregnancy. The research was conducted from August 2004 to January 2006 at All India Institute of Medical Sciences, New Delhi, India. Each woman received a single oral dose of mifepristone 200 mg on D1 followed by 800 μg vaginal misoprostol, 36 to 48 hours later. 4 to 6 hours after the last dose of misoprostol, 4 doses of 400 μg sublingual or vaginal misoprostol were given 3 hourly for a maximum of four doses. Statistical analysis was done using SAS software version 8.2.

RESULTS

Of the 70 women, 1 aborted prior to administration of misoprostol. The median induction abortion interval (IAI) was 6.33 hrs. The average duration of hospital stay was 16 hrs; dose of misoprostol required was 800 μg in 45(64.28%) and 1200μg in 17 (24.28%) women. Complete abortion rate was 91.42 % after 15 hrs of initial misoprostol instillation. Side effects were mild, and 5 (7.14%) women required analgesia. The IAI had no correlation with parity (p=0.33), increasing gestation (p=0.5), and increasing age (p=0.7). 48.6% opted for tubal ligation postabortion.

CONCLUSION

The mifepristone/misoprostol regimen is a highly effective and safe regimen for second trimester nonsurgical termination of pregnancy; with a short induction abortion interval and hospital stay.

Keywords: Mifepristone, misoprostol, second trimester termination of preganncy