Jayasudha, V (2012) Comparative study of mifepristone and vaginal misoprostol combination over vaginal misoprostol alone in first trimester abortion. Masters thesis, K.A.P. Viswanathan Government Medical College, Tiruchirappalli.
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Abstract
INTRODUCTION: MTP act can have an impact on reduction of maternal mortality and morbidity through safe abortion. Where abortion is legal, it is generally reasonably safe, where it is illegal, complications are common, and about 78,000 women die every year from these complications. Regardless of personal feelings about the ethics of interrupting pregnancy professionals have duty to know the medical facts about abortion and share them with their patients. Worldwide, about 46 million women have abortions each year, and about half of these procedures are illegal and considered “unsafe” by the World Health Organization. Unsafe abortion is a “procedure for terminating an unwanted pregnancy either by person lacking the necessary skills or in an environment lacking the minimal medical standards or both”. AIMS AND OBJECTIVES: 1. To assess the efficacy of mifepristone vaginal misoprostol in first trimester abortion. 2. To compare this combination with vaginal misoprostol alone for first trimester MTP. 3. To compare the various parameters involved in MTP in both the methods and asses the most suitable methods for first trimester MTP: I. 50 mifepristone + misoprostol group, II. 50misoprostol group. Mifepristone + misoprostol Day 1 – 200 mg mifepristone was given orally. Day 3 – 400 microgram of misoprostol kept vaginally and abserve 4 hours in op department. Misoprostol group. 400 microgram of misoprostol in posterior fornix repeated 4 to 6 hours apart after admission of patient in ward. Maximum of 3 doses. Following were the observations of this study: 1. Most of the patients were in the age group 21-30 and parous. 2. 4% of patients were unmarried who responded well for medical methods. 3. Almost all patients had various symtoms in both groups. 4. Expulsion was complete in the Mifepristone+Misoprostol group with only 2 woman needing check curettage for confirmation of complete abortion. However in one women, there was no response and their pregnancy was terminated by MVA. On the other hand 48% of women in the Misoprostol alone group had to have curettage for completing the abortion process, and 10% of patients there was no response. 5. Induction-abortion time is less in patients with Mifepristone +Misoprostol than Misoprostol alone (4-5 hours vs 20-22 hrs. respectively). 6. None of the patients needed blood transfusion or volume expanders. 7. None of the patients had delayed bleeding after 45 days. On an average Bleeding stopped within 2 to5 days of expelling products. 8. Misoprostol is less expensive and efficacious. However induction abortion interval is prolonged than Mifepristone +Misoprostol combination. 9. Though Mifepristone is more expensive, the high complete abortion rate and expulsion withing 4-5 hrs of Misoprostol administration makes it a preferred method where cost is not a restraining factor. 1. Mifepristone-Misoprostol combination is an effective out-patient procedure for early MTP and is ideal for home management. 2. Complete abortion rate is high with this combination. 3. Similarly the induction abortion interval with this method is also less. 4. Other associated complications are less. The only confounding factor is the cost involved which is about 20 times that of Misoprostol alone. This makes the routine use of Mifepristone-Misoprostol combination for first trimester abortion an effective option where cost is not a consideration or in situations where and early abortion is required.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | First trimester abortion ; Mifepristone ; Vaginal misoprostone ; Comparison ; Complete abortion ; Post – aortal complications. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 24 Nov 2017 17:40 |
| Last Modified: | 24 Nov 2017 17:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4005 |
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