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Mifepristone plus vaginal misoprostol vs vaginal misoprostol alone for medical abortion in gestation 63 days or less in Nepalese women: A quasi‐randomized controlled trial
Author(s) -
Chawdhary Rashmi,
Rana Ashma,
Pradhan Neelam
Publication year - 2009
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00864.x
Subject(s) - misoprostol , medicine , mifepristone , obstetrics , medical abortion , abortion , gynecology , pregnancy , obstetrics and gynaecology , incomplete abortion , gestation , vacuum aspiration , randomized controlled trial , vaginal bleeding , population , family planning , surgery , research methodology , genetics , environmental health , biology
Aim: To compare the efficacy of mifepristone and vaginal misoprostol with misoprostol alone for pregnancy termination up to 63 days. Method: This exploratory study was conducted in the Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal as a part of a thesis study for a period of one year from April 2005–2006. After confirming a pregnancy ≤63 days gestation by transvaginal ultrasound, an equal number of women (50) were randomized into (i) group A, women who received 200 mg oral mifepristone (RU 486) on day 1 and vaginal misoprostol 800 µg on day 3; and (ii) group B, women who received vaginal misoprostol (800 µg) on day 1 and 3 (total dose 1600 µg). The primary study outcome measure was complete abortion without surgical intervention making comparisons between these two groups in terms of complete abortion rate, need for manual vacuum aspiration for incomplete abortion and pregnancy continuation after reconfirming the diagnosis on transvaginal ultrasound, besides comparing the side effects/complications. Results: Fewer side effects and a more complete abortion rate (94%) was observed in group A (mifepristone and vaginal misoprostol) in comparison to vaginal misoprostol alone (total dose 1600 µg) giving a complete abortion rate of 86% along with a significant hematocrit drop on follow‐up day 10 ( P = 0.03) besides having increased duration of bleeding ( P = 0.017). Conclusion: Mifepristone oral (200 mg) followed by vaginal misoprostol (800 µg) on day 3 provides a better success rate (94%) with fewer complications than vaginal misoprostol 800 µg used on days 1 and 3 for medical abortion of pregnancies up to 63 days.