Is Misoprostol Alone, Administered 24 h a Valid Option for Medical Abortion?
Background: Medical abortion with misoprostol alone has been established as a safe and effective alternative to combined
therapy with mifepristone with misoprostol.
Aims and Objectives: The objective of this study was to evaluate the safety and effi cacy of three doses of 1000 μg misoprostol
administered at 24 h interval, for medical abortion.
Materials and Methods: A total of 60 prospective patients are attending our outpatient department for termination of pregnancy
who fulfi lled the inclusion criteria were included in this study after informed consent. Outcomes measured were: (1) Successful
abortion (complete abortion without requiring additional procedure), (2) side-effects, (3) mean time of onset of cramping, (4) mean
time of onset of bleeding, (5) mean duration of bleeding, (6) mean decrease in hemoglobin and, (7) mean time of menstruation
returning. Medical abortion was successful in 54 of 60 (90%) patients.
Results: The mean change in hemoglobin was 0.7 ± 0.4 g/dl. Cramping began at 5.1 ± 3.4 h and lasted 3.7 ± 1.9 h. Vaginal
bleeding started at 6.46 ± 1.6 h and lasted 7.0 ± 4.6 days. Time to return of menstruation was 37 ± 7.1 days.
Conclusions: The present study suggests that 1000 μg misoprostol administered vaginally at 24 h intervals could be a more
economical and viable option in situations where fi nancial constraints restrict the use of mifepristone. Moreover, the 24 h interval
improves patient compliance and allows outpatient management.
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