Alia Bashir, Nudrat Sohail, Razia Ashraf, Arif Tajammul.
The role of misoprostol as abortificant in first and second trimester of pregnancy.
J Allama Iqbal Med Coll Jan ;7(4):7-10.

Aims and Objectives: To find out the efficacy of misoprostol as abortifacient in first and second trimester abortions as labour inducing agent. And to document any complications specific to this protocol. Study setting: This study was conducted in Obs/Gynae department of Jinnah Hospital, Lahore Study Design: Prospective observational study carried out for a period of one year.Material and Methods Sample size: A total of 50 patients, admitted in the labour ward through emergency or outdoor (booked or un-booked) with first and second trimester missed abortion, anembryonic pregnancy’ blighted ovum of more than 22-23 mm empty sac or abnormal fetus and all those patients in which continuation of pregnancy wass danger to maternal health due to severe medical illness included in the study.Dose of misoprostol: In first trimester of pregnancy and till 16 week: 400 µg 4 hourly maximum of 5 doses intra vaginally and in second trimester of pregnancy from 16 weeks to 24 weeks; 400 µg stat followed by 200µg 4 hourly maximum 5 doses intra vaginally were given. Results: Out of 50 patients, 42 (84%) ended in complete abortion after induction by misoprostol. While 5 (10%) did not abort and need surgical intervention and 3 ended in incomplete abortion followed by surgical evacuation. 80% abortion occur within 24 hour of medical induction The mild side effect nausea and vomiting noted in only 10% of cases. While fever was noted in 4% of cases. Conclusion: It is concluded from our study that misoprostol is effective agent for induction of labour. The use of this agent could eliminate the need for about two third of surgical abortion in first and second trimester of pregnancy. Therefore in countries with limited resources, where the more expensive prostaglandins are unavailable, misoprostol, because of its efficacy, low incidence of side effects and low cost , may prove to be a useful alternative for induction of labour in first and second trimester abortion.

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