Are two doses of misoprostol after mifepristone for early abortion better than one?

OBJECTIVE: The objective of this study was to determine if a repeat dose of misoprostol following mifepristone or a single dose of misoprostol increases the efficacy of medical termination of pregnancy. DESIGN: Randomised, placebo controlled trial. SETTING: K.E.M. Hospital, Pune, India, and the Health Centre, Larsen and Toubro Limited, Mumbai, India. SAMPLE: A total of 300 women seeking an abortion with amenorrhoea of 8 weeks or less. Methods Women were randomised to receive one or two doses of 400 microgram oral misoprostol at the clinic 48 hours after administration of 200 mg mifepristone. Main outcome measure Complete abortion without surgical intervention. Results The repeat administration of misoprostol 400 microgram improved the complete abortion rate from 86 to 92% and significantly reduced the rate of continuing pregnancy from 7 to 1%. Almost all the women who were administered the additional dose of misoprostol were either very satisfied (58%) or satisfied (37%) with the method. Conclusion While an additional oral dose of 400 microgram misoprostol did not significantly increase the rate of complete abortion without surgical intervention, the additional dose did significantly reduce the rate of continuing pregnancies without compromising the acceptability and ease of use of the method.

Mifepristone abortion outside the urban research hospital setting in India.

Medical abortion holds great promise in less-developed countries, where abortion morbidity and mortality remain high. We tested the French mifepristone-misoprostol regimen in two urban outpatient family-planning clinics (n=600) and a rural hospital (n=300) in India. 4% of urban women and 1% of rural women were lost to follow-up. Perfect use and typical-use success rates were as high as European rates at all sites. Although rural women reported fewer side-effects, most women in urban and rural settings were satisfied with their medical abortions. Medical abortion can be offered safely, effectively, and acceptably in urban outpatient clinics and rural hospitals in India.

A study of psycho-social factors of out-of-wedlock pregnancies.

PIP: The study was conducted to find out a relationship between various psychosocial factors which may be a part of the milieu causing girls to become pregnant out of wedlock. 500 girls between the ages of 14-27 years were studied during a period of 1 year. It was revealed that though their physical and mental environment may be one of the causes of their problem, premarital sex is becoming a way of life with youngsters. The teenagers in India have no knowledge about sex and inadequate knowledge about birth control and the capacity to think about the responsibility ensuing thereof is completely lacking. They were not aware of their own biological role in the pregnancy they had come to terminate. Non-recurrence of this situation can be achieved to some extent through a well organized rehabilitation program in centers conducting medical termination of pregnancy as they need social, economic, and mental rehabilitation. There is an urgent and immediate need for sound and proper sex education for all young people and special contraceptive centers must be organized for unmarried people, where they can come without hesitation for advice regarding contraceptive measures. It is important that full confidentiality be maintained.^ieng