RESUMEN
Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.
RESUMEN
Objective(s): To compare the incidence of placenta previa, associated factors, complications, placental position, mode of delivery and fetal and maternal outcome in scarred (Group A) and unscarred uterus (Group B) in 20 months of hospital-based study. Material and methods: In a prospective study, 140 cases of pregnancies beyond 28 weeks of gestation complicated by placenta previa were identified. These cases were divided into two groups, scarred uterus (Group A, n = 34) and unscarred uterus (Group B, n = 106). Total number of deliveries were 16,784 out of which 2,354 patients had cesarean section and 140 patients had placenta previa. Results: The incidence of placenta previa in scarred cases is significantly higher (1.2%) than overall incidence (0.6%). Majority of scarred cases had anterior placenta (85.2%) and majority of unscarred cases had posterior placenta (63.2%) (p value -0.00, HS). The number of unbooked cases in both Groups A and B was high (P value-0.404, NS). A significant association of placenta previa following curretage in Group B was observed (p value-0.002, S). There was only one maternal mortality in Group B and none in Group A. Results showed a favorable fetal outcome in both groups. (Group A-70.6%, Group B-64.2%, p value-0.08, NS). Conclusion(s): An increase in the incidence of prior cesarean section and advanced maternal age probably contribute to a rise in the number of pregnancies complicated with placenta previa and its association with adverse maternal and perinatal outcome.