DOI: https://doi.org/10.36347/sjams.2024.v12i11.030

Pages: 1623-1626

Background: Medical termination of pregnancy (MTP) during the mid-trimester, typically between 13 and 24 weeks of gestation, presents significant challenges, particularly in low-resource settings like Bangladesh. Misoprostol, a prostaglandin E1 analogue, is widely used for mid-trimester abortions due to its efficacy, ease of administration, and affordability. However, its safety in women with a prior caesarean section remains a concern, especially regarding the risk of uterine rupture. This study assesses the efficacy and safety of intravaginal misoprostol for mid-trimester pregnancy termination in Bangladeshi women. Objective: To evaluate the efficacy and safety of intravaginal misoprostol for mid-trimester pregnancy termination in women with and without a prior caesarean section in Bangladesh. Methodology: This prospective study was conducted at a tertiary care hospital in Bangladesh from January 2019 to December 2022. A total of 200 women requiring mid-trimester MTP were enrolled, with 100 women having a prior caesarean section (study group) and 100 women without such a history (control group). Women were administered 400μg of intravaginal misoprostol every 6 hours for a maximum of five doses. The efficacy of complete abortion and the incidence of complications, including hemorrhage, infection, retained placenta, and uterine rupture, were recorded. Results: Both groups demonstrated high rates of successful mid-trimester terminations with no cases of uterine rupture. In the study group (previous caesarean), 2 women experienced severe hemorrhage, 3 had post-abortal infections, and 10 required management for retained placenta. In the control group, 3 women had severe hemorrhage, 5 had post-abortal infections, and 11 experienced retained placenta. No significant differences in complication rates were found between the two groups. Conclusion: Intravaginal misoprostol is effective and generally safe for mid-trimester pregnancy termination, even in women with ...