DEMOGRAPHIC AND CLINICAL PREDICTORS OF INDUCTION-ABORTION INTERVAL IN SECOND-TRIMESTER MEDICAL ABORTION WITH MISOPROSTOL: A RANDOMIZED CONTROLLED TRIAL ANALYSIS
Main Article Content
Keywords
.
Abstract
Objective: To identify demographic and clinical factors influencing the induction-abortion interval (IAI) among women undergoing second-trimester medical abortion with vaginal misoprostol.
Methods: This prospective randomized controlled trial enrolled 60 women (18–40 years, 13–24 weeks gestation, singleton pregnancy) who received mifepristone 200 mg orally followed by vaginal misoprostol administered as either a loading-dose regimen (Group A, n=30) or a non-loading regimen (Group B, n=30). Baseline demographic and clinical variables including age, body mass index (BMI), gravidity, parity, gestational age, abortion indication, and prior obstetric history were recorded. The primary outcome was the induction-abortion interval (hours from first misoprostol dose to complete abortion). Univariate and multivariate analyses assessed predictors of IAI.
Results: Median IAI was significantly shorter in the loading-dose group compared to the non-loading group (7.88 hours [IQR 7.02–9.03] vs. 13.21 hours [IQR 11.64–15.74], p<0.001).
On univariate analysis, greater gestational age and primigravida status were associated with longer IAI, while parity, age, BMI, indication, and prior abortions were not significant predictors.
Multivariate regression revealed that only the use of a vaginal misoprostol loading-dose regimen (β = −4.7 hours, p<0.001) and lower gestational age (β = +0.14 hours per day increase, p=0.03) independently predicted a shorter IAI.
No significant influence of age, BMI, abortion indication, or previous obstetric history on IAI was observed.
Conclusion: Use of a vaginal misoprostol loading dose and earlier gestational age are independent predictors of shorter induction-abortion interval in second-trimester medical abortion, aiding optimized clinical counseling and management.
References
2. Dickinson JE, Doherty DA. Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality. Prenat Diagn. 2009;29(5):520–4.
3. Pongsatha S, Tongsong T. Randomized controlled trial comparing efficacy between a vaginal misoprostol loading and non-loading dose regimen for second-trimester pregnancy termination. J Obstet Gynaecol Res. 2014;40(1):155–60.
4. Ashok PW, Templeton A. Nonsurgical mid-trimester termination of pregnancy: a review of 500 consecutive cases. Br J Obstet Gynaecol. 1999;106(7):706–10.
5. Ting WH, Peng FH, Lin HH, Lu HF, Hsiao SM. Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol. Taiwan J Obstet Gynecol. 2015;54(4):408–11.
6. Bhattacharyya SK, Mukherji J, Kamilya GS, Ray S, Hazra A. Two regimens of vaginal misoprostol in second trimester termination of pregnancy: a prospective randomized trial. Acta Obstet Gynecol Scand. 2006;85(12):1458–62.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Ishu Mehta
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
Ashish Kumar
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
Drishti Rana
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
Anjali Soni
Department of Obstetrics and Gynecology, Dr. Radhakrishnan Government Medical College, Hamirpur, Himachal Pradesh, India
Mamta Mahajan
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
Manmeet Saini
Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
Abhinav Gautam
Department of Pediatrics, Dr Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India