Original article

Neelam Sharma^1,*, Anshul Jhanwar²


Affiliation:-
¹Assistant Professor, Department of Obstetrics & Gynecology, Jhalawar medical college, Jhalawar, Rajasthan, India
²Assistant Professor, Department of Pharmacology, Jhalawar medical college, Jhalawar, Rajasthan, India

The name of the department(s) and institution(s) to which the work should be attributed:
Department of Obstetrics & Gynecology, J.L.N. medical college, Ajmer, Rajasthan, India

Address reprint requests to
Dr. Anshul Jhanwar.
III/2,Doctor’s residence, Medical College Campus, Jhalawar, Rajasthan, India (Pin-326001)

Article citation:
Sharma N, Jhanwar A. To study the effect of Mifepristone-Misoprostol combination for first trimester abortion in cases with previously scarred uterus. J Pharm Biomed Sci 2014; 04(08):930-935. Available at www.jpbms.info

ABSTRACT
Introduction: In India to deal with unwanted pregnancy in the scarred uterus is thorny situation, since the caesarian section rate is increasing. Although most widely used method for terminating pregnancy is dilatation and evacuation but it increases morbidity and mortality by causing uterine perforation, serious hemorrhage and shock. Therefore medical abortion offers an advantageous alternative to surgical abortion.
Material and methods: Total one hundred and fifty patients were selected for the present prospective study and were divided randomly into two equal groups after fulfilling the inclusion and exclusion criteria. Both groups were given 200 mg Mifepristone followed by 800 µg Misoprostol after 48 hours. Group 1 consist of patients with previously scarred uterus. Group 2 consisted of patients with previously non-scarred uterus.
Results: Mean period of gestation in group 1 was 43.48 days and in group 2 was 43.81 days. Mean gravidity in group 1 was 3.24 and in group 2 was 3.17.Mean parity in group 1 was 2.2 while in group 2 was 2.14.Efficacy of procedure which was determined by the number of complete abortions in the group (92% in group 1 and 93.3% in group2.Minor side effects were seen in 21 % patients of group 1 as compared to 28% in group 2.
Conclusion: Both the groups who underwent medical abortion with mifepristone-misoprostol combination were found to be comparable in terms of efficacy, safety and acceptability for termination of pregnancy of gestational age upto 49 days.


KEYWORDS: Mifepristone, Misoprostol, Scarred uterus, Lower segment cesarean section. 


REFERENCES

1.Norman JE et al. Uterine contractility and induction of abortion in early pregnancy by misoprostol and mifepristone. Lancet 1991; 338:1233-1236.
2.Abraham Debby et al. Mid trimester abortion in patients with a previous uterine scar. European Journal of Obst & Gyne 2003.
3.Maitre SC,Bouchard P,Spitz IM .Medical termination of pregnancy.N Engl.J Med 2000;342:946-56.
4.Wu Y,Medical progress in China-Family planning.Natl Med J China 1995;75(12):749-75.
5.Creinin MD. Medical abortion regimens. Historical contest and overview. Am J Obstet & Gynecol 2000; 183:53-59.
6.Belfort P,Pinotti JA,Eskes Tkab.Fertility,sterility and contraception. Caterton Hall, Carnforth, UK: The Parthenon Publishing Group.1989; 28-31.
7.Bygdeman M. Termination of pregnancy upto 8 or 9 weeks-Modern methods of inducing abortion. Black-well science:Oxford;1995:39-53
8.Sun H,Wu S,Xu H et. Al.The potential of Ru 486 for medical termination of pregnancy: An acceptability and feasibility study. J Repro Med (China). 1995; 4(3):749-75.
9.Coyaji K,Etul B,Krishna U,Otiv S, Ambardekar S,Bopardikar A: Mifepristone abortion outside the urban research hospital setting in India.Lancet,2001;357:120-22.
10.Brogden RN, Goa KL, Faulds D. Mifepristone: A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential. Drugs 1993; 45:384-409.
11.Renee M, Hart S. Mifepristone: Annuals of pharmacotherapy 2001;35:707-15.
12.Robbins A,Spitz IM. Mifepristone clinical pharmacology. Clin Obstet Gynecol 1996;39:436-50.
13.Berghella V,Airoldi J. Misoprostol for first trimester pregnancy termination in women with prior cesarean;a systemic review. BJOG;May 2009.
14.Muhammad Fawzy. Mid trimester abortion using vaginal misoprostol for women with 3 or more prior cesarean deliveries. JJOG 2010 March.
15.Premila W,Prabath T. Factors affecting outcome of early medical abortion: A review of 4132 consecutive cases; BJOG: Nov 2002;109:1281-89.
16.J Xu, Chen H. Termination of early pregnancy in scarred uterus with mifepristone and misoprostol. IJOG.72 (2001):245-51.


Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patients and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.

Disclosure forms provided by the authors are available with the full text of this article at jpbms.info


Copyright © 2014 Sharma N, Jhanwar A. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.