A COMPARATIVE STUDY OF THE SAFETY AND EFFICACY OF SECOND-TRIMESTER MEDICAL ABORTION – MIFEPRISTONE PREINDUCTION FOLLOWED BY MISOPROSTOL VERSUS FOLEY CATHETER AND MISOPROSTOL
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 600-623
AbstractIntroduction: The term "abortion" refers to the natural or artificial termination of a pregnancy prior to foetus viability. The second trimester, which is divided again into early and late periods, lasts from 13 to 28 weeks of gestation. Because of foetal abnormalities such as chromosomal aneuploidy, structural defects, and oligohydramnios discovered by antenatal screening programmes, many second trimester abortions are medically induced (resulting in intrauterine foetal demise). The combination of antiprogestin (mifepristone) and PGE1 analogue Misoprostol seems to be the most effective medical technique for ending a pregnancy in the second trimester.
Aims and Objectives: To evaluate the safety and effectiveness of two medical procedures for an abortion in the second trimester: preinduction with mifepristone followed by a misoprostol regimen (group 1), and preinduction with a foley cather followed by a misoprostol regimen (group 2). (Group 2). In order to make a comparison between the length of time that passed between the induction and the abortion in both groups, we will compare the length of time that passed. In order to provide an accurate assessment of the disparity in abortion rates between the two populations:
Methods: This study is a prospective randomized trial involving sixty healthy women who chose to have their pregnancies terminated at a tertiary care center's Department of Obstetrics and Gynecology. The women's ultrasounds confirmed an intrauterine gestational age ranging from thirteen to twenty-six weeks of pregnancy.
Results and discussion: Group 1's average induction abortion time was 8.93 hours, whereas group 2's was 8.75. None was statistically significant. 42 women who used mifepristone and misoprostol had IAIs under 6 hours, according to Bijeta et al. The average IAI for Mifepristone + Misoprostol was 8.6 hours and 15.5 hours for Misoprostol. Hourly comparison of mifepristone-misoprostol induction abortion studies: Neha Agarwal et al. found a 6-hour IAI. Sin Eh Goh et al. found a 6.7-hour average IAI. Kulakarni Kranti's average IAI was 8.15 hours. Tang et al. found a 10.5-hour IAI. Ashok et al. found a 6.25-hour IAI. In Subha et altrial, the foley catheter termination group received misoprostol after 13.84 5.37 hours.
Conclusion: Both the mifepristone preinduction with misoprostol and the foley catheter preinduction with misoprostol procedures are risk-free and simple ways for terminating a pregnancy in the second trimester. There was no statistically significant difference between the two groups in terms of the mean induction-abortion interval, the mean doses of misoprostol required, the side-effect profile, or the rate of women who experienced a complete abortion. In the group that used mifepristone and misoprostol, the success rate was 100%, while in the group that used foley bulb induction, the success rate was 96.7%. In this particular trial, the group that received mifepristone and misoprostol had a significantly lower level of pain intensity and a shorter length of time spent in the hospital. This difference was statistically significant. Therefore, it is possible to utilise either of these approaches to stop a pregnancy in the second trimester, although this will rely on whether or not mifepristone is readily available.
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