A RETROSPECTIVE STUDY TO EVALUATE THE OUTCOMES AND INDUCTION–ABORTION INTERVAL IN PATIENTS WHO UNDERWENT SECOND-TRIMESTER MEDICAL TERMINATION OF PREGNANCY AT A TERTIARY CARE CENTER
Main Article Content
Keywords
Second-Trimester Abortion, Medical Termination, Extra Amniotic, Mifepristone, Misoprostol, Normal Saline.
Abstract
Background
Second-trimester abortion, defined as termination between 13 and 28 weeks of gestation, is an essential aspect of women’s reproductive healthcare. It is often indicated due to fetal anomalies, intrauterine demise, or maternal health concerns. Compared to first-trimester procedures, second-trimester abortions carry a higher risk of complications and require effective, evidence-based management strategies.
Objective
To evaluate the clinical outcomes and induction–abortion interval in patients undergoing second-trimester medical termination of pregnancy using various induction methods at a tertiary care center.
Methods
This retrospective hospital-based study was conducted over 18 months from October 2023 to March 2025 in the Department of Obstetrics and Gynaecology at Government General Hospital, Vijayawada. A total of 107 patients undergoing second-trimester medical termination (13–28 weeks) were included. Of these, 67 cases were managed using extra amniotic Normal saline insertion via Foley catheter followed by misoprostol, and 40 cases received a combination of mifepristone and misoprostol. Data on indications, induction methods, and outcomes were extracted from hospital records and analyzed.
Results
The most common indication for second-trimester termination was congenital anomalies (50.4%), followed by intra uterine death (26.7%) Failed contraception (14%) unmarried status (9.3%). The extra amniotic method demonstrated high success with acceptable induction-abortion intervals and low complication rates. Mifepristone-misoprostol showed moderate induction-to-expulsion time. Retained products requiring evacuation occurred in 11.2% cases.
Conclusion
Congenital anomalies remain the leading cause of second-trimester medical termination. With appropriate induction methods, second-trimester abortion can be effectively and safely managed. The findings underscore the importance of timely diagnosis and standardized protocols to reduce associated morbidity. The extra amniotic method remains a reliable and cost-effective approach for second-trimester MTP, particularly in low-resource settings. Broader training and advanced protocols are recommended to enhance outcomes.
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Dr. R. Sowjanya
Professor Department of Obstetrics & Gynaecology, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.
Dr. J. Anuradha
Associate Professor Department of Obstetrics & Gynaecology, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.
Dr. Mobine Ahamad S.
Assistant Professor Department of Obstetrics & Gynaecology, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.
Dr. B. Niveditha
Second Year Postgraduate, Obstetrics & Gynaecology, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.