Efficacy and acceptability of medical abortion with mifepristone and misoprostol in early pregnancy

Abstract

In many countries including India, the only method for termination of early pregnancy has, until recently been surgical namely vacuum aspiration. However, with the medical method, general anesthesia and surgery together with the potential complications related to their use can be avoided. To present the new procedure as an alternative to the surgical method, health care providers need to know its user potential. Valuable opinion for further development of the method can also be obtained from the opinion of women who have undergone the procedure. The success rate of medical abortion in the current study is 90.32%. This can be further increased with either higher dose of misoprostol, or with sublingual misoprostol or any of the previous routes with further follow up with misoprostol administration. This prospective observational follow up study was conducted in a tertiary care hospital in large urban area, where back up facilities are easily available and of reasonably good quality. This study was conducted in the Department of Obstetrics and Gynaecology, I.P.G.M.E & R, Kolkata from 1st June 2010 to 31st May 2011. for the study, A group of 80 early pregnancy abortion seekers (≤ 7weeks of gestation) who attended Out Patient Clinic / Medical Termination clinic of I.P.G.M.E & R / S.S.K.M Hospital, Kolkata were taken. The sample was designed according to the following mentioned inclusion and exclusion criteria. All those patients, who attended Out Patient Clinic of Department of Obstetrics & Gynaecology and satisfied the following selection criteria, were included in the study. Women who undergo medical abortion experience much more bleeding either in amount or in duration than do surgical patients. Since women’s expectations may significantly affect their comfort and satisfaction with a method, medical abortion patients must receive appropriate counseling to prepare them for the method’s potential side effects and to judge correctly when an unscheduled visit to the clinic is necessary. Acceptability of low dose mifepristone – misoprostol regimen in the population studied is quite high and women having past experience of surgical abortion have a preference towards surgical abortion. Nevertheless medical abortion is a revolutionary technique and our study results indicate that mifepristone-misoprostol medical abortion can complement available surgical services and help meet the long standing need for safe abortion.