ABSTRACT
BACKGROUND: Unsafe abortion is a major cause of mortality among women in India accounting for 12% of all maternal deaths. In developing countries, annually, up to 200,000 women die of complications after illegal abortion. Medical abortion is potentially a simple and a safe method for use in developing countries. We conducted a prospective controlled trial to compare the efficacy of low-lose mifepristone and methotrexate for medical abortion. OBJECTIVE: To find out the efficacy of low-dose mifepristone and methotrexate for inducing abortion. METHOD: In this prospective clinical study, 100 women opted for a medical method of abortion. Out of these, 50 patients were given 50 mg/m2 of methotrexate intramuscularly followed by 800 micro gm of intravaginal misoprostol, and 50 patients were given 200 mg of mifepristone orally followed by 800 micro gm of intravaginal misoprostol. MAIN OUTCOME MEASURES: Complete abortion was the principal outcome measure. Secondary outcome measures were side effects and acceptability data. RESULTS: The rate of expulsion by first week after initiation of treatment was 58% in methotrexate and 98% in mifepristone group (P <0.001). CONCLUSION: Low-dose mifepristone and intravaginal misoprostol is safe, effective, and well tolerated as compared to methotrexate and misoprostol.
Subject(s)
Abortifacient Agents/administration & dosage , Abortion, Induced/methods , Adult , Chi-Square Distribution , Drug Therapy, Combination , Female , Humans , Methotrexate/administration & dosage , Mifepristone/administration & dosage , Misoprostol/administration & dosage , Pregnancy , Prospective Studies , Treatment OutcomeABSTRACT
Cesarean section many a times, has to be done late in labour when the head is deeply wedged in the pelvis. The techniques described in standard text books, usually result in extension of the incision either laterally into the broad ligament or vertically upwards into the upper segment or downwards posterior to the bladder from the centre of the incision line. In this study we have reviewed the Patwardhan's technique for the extraction of baby and fetomaternal outcome was compared with cases where this technique was not used. There was no extension of the incision either laterally into broad ligament or upwards or downwards. Haemorrhage due to extension of incision requiring blood transfusion occurred in 24% of patients in group II as compared to nil in group I.