Is Mifepristone Needed for Second Trimester Termination of Pregnancy?

Objectives: To assess the safety, efficacy and the induction-abortion interval of combination of mifepristone/misoprostol for termination of pregnancy in the second trimester between 13 to 20 weeks gestation. Materials and Methods: We performed a retrospective analysis of prospectively collected data among 70 healthy pregnant women aged 16 to 40-years, requesting second trimester termination of pregnancy. The research was conducted from August 2004 to January 2006 at All India Institute of Medical Sciences, New Delhi, India. Each woman received a single oral dose of mifepristone 200 mg on D1 followed by 800 mu g vaginal misoprostol, 36 to 48 hours later. Four to 6 hours after the last dose of misoprostol, 4 doses of 400 mu g sublingual or vaginal misoprostol were given 3 hourly for a maximum of four doses. Statistical analysis was done using SAS software version 8.2. Results: Of the 70 women, 1 aborted before administration of misoprostol. The median induction-abortion interval (IAI) was 6.33 hrs. The average duration of hospital stay was 16 hrs; dose of misoprostol required was 800 mu g in 45 (64.28%) and 1200 mu g in 17 (24.28%) women. Complete abortion rate was 91.42% after 15 hrs of initial misoprostol instillation. Side effects were mild, and 5 (7.14%) women required analgesia. The IAI had no correlation with parity (p=0.33), increasing gestation (p=0.5), and increasing age (p=0.7). Of the patients 48.6% opted for tubal ligation postabortion. Discussion: The mifepristone/misoprostol regimen is a highly effective and safe regimen for second trimester nonsurgical termination of pregnancy; with a short induction abortion interval and hospital stay.