A PROSPECTIVE COMPARATIVE STUDY OF VAGINAL VERSUS ORAL MISOPROSTOL ONLY REGIMEN FOR EARLY SECOND TRIMESTER PREGNANCY TERMINATION

Abstract

Background: Medical methods for second trimester abortion are being favoured now a day over surgical methods .Out of various medical methods available misoprostol only regime is a cheap, safe and readily available method which can be used in various doses and by various routes. Comparison between vaginal and oral route of misoprostol forms the basis of this study.

Methods: This was a prospective comparative study of misoprostol for second trimester abortion between 12-20 weeks, comparing vaginal and oral routes.120 patients were randomly allotted to two groups 60 received vaginal misoprotol 400 µgms 4 hourly upto maximum of 4 doses and 60 patients received oral misoprostol with water in same dose and duration. In both groups, oxytocin infusion was started if abortion did not occur. Efficacy, induction abortion interval and need of surgical evacuation were analysed.

Results: Both groups were well matched in terms of age, parity .Mean gestational age and indication for MTP. The mean induction-abortion interval was 10.71± 2.21 hours for vaginal group and it was 14.73± 01.73 hours with oral route. The complete abortion rate was almost 75% for vaginal group but only being 55% for oral route. The failure rate was 25% with oral route compared 15% with vaginal group.

 Conclusions: Though both vaginal and oral misoprostol are safe, vaginal route appears to be more efficacious for second trimester MTP.

Keywords:  abortion interval, misoprostol, second – trimester MTP.