OUTCOMES OF INDUCED MEDICAL ABORTION IN FIRST TRIMESTER OF PREGNANCY: REPORT FROM A TERTIARY CARE HOSPITAL

Background: Medical abortion is a safe, effective and affordable method of termination of pregnancy. Success rate is 92 - 97%. When performed as per guidelines. After legalisation of medical abortion in India in 2002, abortion pills are available over the counter throughout the country. This has led to unsupervised use of such method and subsequent complications. Objective:To study the demographic profile and outcomes of induced medical abortion in first trimester of pregnancy. Materials and methods: This is a hospital based prospective observational study undertaken in the department of Obstetrics & Gynaecology, S.C.B. Medical College, Cuttack during the period of one year from August 2015 to July 2016. Women between 15 to 45 years in first trimester of pregnancy admitted the department either through emergency or OPD after taking combined abortificient drugs (mifepristone & misoprostol combinations) elsewhere were included in the study. Results: Out of 123 cases 91.8% were married, 61.8% were from early reproductive age group 74.4% (20 to 30 years) are from rural area and 78.9% belongs to low socio-economic section. 91.1% women taken these drugs either through over the counter or from huregistences medical practitioner. 78.9% of women taken the drug within 9 weeks gestation (63 days). 88.6% of cases presented to the hospital with excessive vaginal bleeding and 43.9% with abdominal pain. Incomplete, complete and septic abortion was detected in 73.9%, 10.6 and 12.2 percent of cases respectively. 38.2% were detected to have severe anaemia and 57.7% moderate anemia, 47.2% needed blood transfusion, 3 (2.4%) patients expired due to anemia, sepsis, shock and ARF. Conclusions: Most of the women are young, less educated and low socio-economic status. Incomplete abortion, bleeding PV with anemia and infection were common outcomes. Large prospective studies are required to assess the magnitude of the problem.