European Journal of Molecular & Clinical Medicine

Abstract

Background: Abortion is a major social &health issue in India. It is estimated that nearly 15 million abortions are taking place in our country every year. About 15,000 to 20,000 women die from complications arising out of legal abortions every year. Aim: The aim of the  present  study was to compare efficacy of the vaginal misoprostol alone versus extra amniotic instillation of ethacridine lactate followed by vaginal misoprostol for second trimester(13 to 20 weeks of gestation) termination of pregnancy. Materials and Methods: This study was a prospective, randomized and comparative study which was conducted in the Department of Obstetrics and Gynaecology, for a period of 1 year. A total of 53 patients were selected and divided into 2 groups. In group 1 (28 patients) vaginal misoprostol 400 mcg was inserted followed by every 4^th hourly up to maximum five doses or untill expulsion of the fetus. 25 women were allocated to group 2,  Ethacridine lactate followed by vaginal misoprostol was administered and all of them received the intervention. Results: Mean IAI in Misoprostol Alone group was 14.93 ± 2.04 hours and in Combined group was 9.72 ± 1.10 hours .The difference was significant(P<0.001). In Misoprostol group, 85.7% had complete abortion and 14.3% underwent Suction & Evacuation i/v/o retained products of conception, in Combined group, 96% had complete abortion and 4% required Suction & Evacuation i/v/o retained products of conception. The difference was not statistically significant.(P<0.201). There were  no significant side effects seen in either group. Conclusion: Combined extra amniotic instillation of ethacridine lactate followed by vaginal misoprostol  is more effective than vaginal misoprostol alone  for second trimester termination of pregnancy, resulting  in shorter induction  to abortion intervals. Use of either  method was safe with regard to side effects observed and completion of procedure.