: Role of combined mifepristone and misoprostol verses misoprostol alone in induction of second trimester abortion- A Randomized Comparison between their outcome…
Sharmin Abbasi (BD), Sehereen Siddiqua (BD)
[Abbasi] Anwer Khan Modern Medical College Hospital, [Siddiqua] Anwer Khan Modern Medical College Hospital
Objectives: To compare the effectiveness, induction to delivery interval ,safety and side effects of combination of mifepristone and misoprostol versus misoprostol alone in induction of second trimester abortion. Materials and Methods: It is a Prospective randomized comparative study in AKMMCH among 109 patients. GA 12-26 weeks. Inclusion criteria- gravida up to fourth, single or multiple preg, h/o of c/s or myomectomy ,normal coagulation profile, no low lying placenta or placenta previa. In Group-A Tab. mifepriston 200mg given orally 24-36 hrs before misoprostol. 600 µgm of misoprostol 6 hrly in post.fornix, if <22 weeks . >22weeks 200 µgm misoprostol 6 hrly in post fornix. Doses were repeated every 6 hourly interval if required.Group-B induction given by 600 µgm of misoprostol 6 hourly in post.fornix,<22 weeks of gestational age .>22weeks started with 400 µgm of misoprostol 6 hourly in post fornix. Maximum 5 doses of misoprostol were allowed. Oxytocin was given if needed. Results: Induction to delivery time was 12-14 hrs in combined group and only misoprostol group it was about 24-36 hrs (P=.006). Doses of misoprostol was lower in combined group1.23±.77 than misoprostol only group 3.41±.59 and which was significant (P<0.001). 4 (7.40%) patients need Oxytocin in only misoprostol group. Risk of fever, gastrointestinal symptoms, postpartum hemorrhage, hyperstimulation, retained placenta, analgesia required more in misoprostol only group but did not differ significantly. In combined group successful induction was in 54 patients (98.18%) in contrast to only misoprostol group (90.74%) . Hospital stay was 12-18 hours in combined group and 24-36 hrs in misoprostol only group. Conclusion : In induction of second trimester abortion mifepristone plus misoprostol is safe, easily tolerable and more effective than conventional use of misoprostol alone.