Abstract: Background: The Medical Termination of Pregnancy Amendment Act, 2021 allows abortion upto 20 weeks for social reasons, upto 24 weeks for Rape victims and also beyond 24 weeks for if substantial fetal anomalies diagnosed in designated centers and under supervision. Second trimester abortions are associated with relatively higher maternal risk when compared to first trimester abortion. With advances in pharmacology, medical abortion is being preferred over surgical methods. This study aims to evaluate the efficacy of misoprostol alone versus mifepristone and misoprostol in second trimester abortions.
Materials and methodology: 300 pregnant women with singleton pregnancies of gestational age between 14-20 weeks, presenting to the OPD of Department of Obstetrics over 1 year were included into the study. 300 patients were divided into 2 groups - group 1 received intra-vaginal misoprostol and group 2 received oral mifepristone with intra-vaginal misoprostol. The demographics and characteristics of abortion were compared within both groups.
Results: most of the women in both groups belonged to 21-30 years of age group, were married and belonged to lower socioeconomic status. Majority of the women were multigravida. The misoprostol only group reported a higher dose of misoprostol requirement, higher incidence of retention of products of conception, higher failure rate and higher volume of blood loss.
Conclusion: pretreatment with mifepristone followed by misoprostol is the ideal method of medical abortion in second trimester as it is associated with few complications. However, the most cost-effective method is use of intra-vaginal misoprostol alone.
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