Prospective Comparative Study of Misoprostol Alone Versus Mifepristone Plus Misoprostol for Second-Trimester Pregnancy Termination

Introduction

MTP has been legalized in India through the Medical Termination of Pregnancy Act, of 1971, which allows pregnancy termination up to 20 weeks. The present study included second-trimester pregnancy terminations and the main aim of the study is to compare the efficacy and safety of tablet mifepristone 24 h before vaginal tablet misoprostol in group-I with vaginal tablet misoprostol alone in group-II as a method of second-trimester pregnancy termination.

Methodology

It was a prospective randomized comparative study conducted at the Department of Obstetrics and Gynaecology, R.N.T. Medical College, Udaipur, Rajasthan, by selecting 100 patients, with equal no, i.e., 50 in each group who attended the inpatient department for second-trimester pregnancy termination (who were fulfilling the criteria as per MTP Act).

Results

From the data analysis of 100 subjects in this study, we observed that the most common indication for second-trimester pregnancy termination was indication (III), which accounts for a total of 60%. Majority of the patients in either group were in the age group between 20 and 30 years, and there was more multigravida as compared to primigravida. The induction termination interval in the Mife-Miso group (group-I) was shorter, i.e., 10.21 h as compared to the Miso group (group-II), i.e.,18 h, and the difference between them was found to be statistically significant (P-value 0.004). The complete expulsion rate within 24 h in group-I was 92% as compared to 72% in group-II.

Conclusion

The pretreatment with oral mifepristone, provides a more safe, non-invasive, and effective regimen for second-trimester termination of pregnancy, which significantly reduces induction termination interval with more success rate.

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