A prospective trial using mifepristone and vaginal misoprostol in termination of pregnancies up to 63 days of gestation

Abstract

Purpose: According to the Consortium on National Consensus for Medical Abortion in India, on average about 11 million abortions take place annually, and around 20,000 women die every year due to abortion-related complications. This study was undertaken to determine the efficacy and the side effect profile of a regime of 200 mg of mifepristone administered orally followed by 800 µg of vaginal misoprostol after 48 h.

Methods: 50 cases of medical abortion meeting the inclusion criteria were included. On day 1, 200 mg of oral mifepristone was given. On day 3, the patient was called back, and 800 µg of Misoprostol administered per vaginum and was observed for 6 h. The patients were then called back for review after two weeks to make sure that the abortion was complete. Although, in most cases, this was clinically evident, an ultrasonography was repeated to confirm the completion.

Results: Out of the 50 patients, four were lost to follow up, and of the remaining 46 patients, abortions were complete in 44 (95.65%), while two (4.35%) patients required surgical intervention.

Conclusions: Medical abortion with 200 mg oral mifepristone and 800 µg vaginal misoprostol is an effective, safe, reliable, and noninvasive method with a success rate of 95.65%. The availability of this low-cost medical treatment using agents which do not require special cold storage and transport facilities and negligible operating theater time makes this provision of safe abortion feasible in settings especially of developing countries, like India, where medical facilities are limited.

Comment: Especially in settings where surgical abortion will be difficult, a medical method with the combination mifepristone and misoprostol is a safe and effective alternative, at least up to 9 weeks amenorrhoea. (HMV)