Efficacy and Safety of Intravaginal Misoprostol for Mid-trimester Medical Termination of Pregnancy

Misoprostol has been widely used in Obstetrics and Gynecology for cervical priming, medical abortion and induction of labour. The purpose of the present study was to evaluate the efficacy and safety of intravaginal misoprostol in mid-trimester medical termination of pregnancy. This non-randomized clinical trial was carried out in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2007 to June 2008 for a period of one year. Primi- or multigravid women with 13 to 28 weeks of singleton pregnancy, fetal congenital malformation and missed abortion who were selected for medical termination of pregnancy were included in this study. Women with spontaneous labour, low laying placenta, ruptured membrane with or without chorioamnionitis, acute bronchial asthma, glaucoma, history of hypersensitivity of PGs, uncontrolled hypertension, cardiac disease, jaundice, renal disease were excluded from this study. The selected patients received 200μg of misoprostol 6 hourly pervaginally upto 48 hours. The outcome variables were induction of delivery time, number of doses within 48 hours, result of induction, surgical evacuation, bleeding after induction, requirement of blood transfusion and Dinoprostone gel; side effect & complication of misoprostol were recorded. A total number of 30 women were recruited for this study. Delivery within 24 and 48hours were 43.3% cases and 38.3% cases respectively. Surgical evacuation was needed in 23.33% cases. Cramping (26.7%), had nausea (10.0%), vomiting (10.0%) and fever (26.7%) were reported. Out of all respondents 90.0% had average and 10.0% had more than average bleeding. For termination of pregnancy 200μg of intravasinat misoprostol are safe and effective in mid-trimester.