Misoprostol + Mifepristone Vs. Misoprostol Alone in Second Trimester Termination of Pregnancy

The present study assessed and compared the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone for second-trimester termination of pregnancy.

The study included 100 women for second-trimester termination of pregnancy, divided into two equal groups, where Group A patients received 200 mg of oral mifepristone followed by 400 mcg of vaginal misoprostol after 48 h, and then 400 mcg of vaginal misoprostol every three hourly until complete expulsion or a maximum of 6 doses. Group B patients received 400 mcg of vaginal misoprostol every three hours until complete expulsion or a maximum of 6 doses.

The study observed-

• Complete abortion in 92% and 72% of cases in Group A and Group B, respectively. 
• The mean induction abortion interval was 11.59 ± 2.71 h in Group A and 15.57 ± 2.27 h in Group B.
• The combination regimen required less average dose of misoprostol than the misoprostol alone group. 
• The combination regimen had lesser side effects than the misoprostol alone group.

The combination of mifepristone and misoprostol is a safer and more effective alternative than using misoprostol alone for terminating a pregnancy in the second trimester.

Nayak AK, Mishra S, Mishra S., et al. Randomised Control Study of Misoprostol and Mifepristone versus Misoprostol Alone in Second Trimester Termination of Pregnancy. J Obstet Gynecol India. 2023. https://doi.org/10.1007/s13224-023-01800-9