Authors : Divya Pandey, Monika Gupta, Sudha Salhan
DOI : 10.18231/j.ijogr.2019.034
Volume : 6
Issue : 2
Year : 2019
Page No : 144-149
Introduction: With the passage of MTP act and later its amendment, abortion was legalised in India. There are clear guidelines on who should prescribe the pills. But owing to over the counter availability of the abortion pills, its self-prescription is widely rampant.
Aims: This study aims to analyse the effects of unsupervised self-prescription of abortion pill on the maternal health.
Materials and Methods: This was an observational study done on 100 consecutive women of reproductive age group (15-45 years) seeking advice at Family planning OPD or Gynaecology emergency department of a tertiary teaching institute after self-prescription of abortion pill. The socio-demographic parameters along with source of pill procurement, gestational age at pill intake, time since pill intake, clinical presentation, medical management or surgical intervention and the final outcome was noted and analysed.
Results: The 100 women sought medical advice over 4 months duration. Of them, 75% were multipara, 77% were urban dwellers and 83% belonged to low socio-economic status. Source of procurement was ultimately the pharmacists for all women.72% women took pill after 7 weeks of gestation and15% took it in second trimester. 55% presented to the health facility within 2 weeks of pill intake. Lack of use of regular contraception was the basic reason behind all women. Only 5 % took the abortion pill with proper regime.30% had incomplete abortion, 20% had incomplete abortion with shock,15% had incomplete abortion with sepsis,25% had failed abortion and 8% presented with shock and severe anemia with only 2% with complete abortion. Although 100% women had complete recovery, yet surgical intervention was needed in 76% women. Evacuation was done in 69%, additional misoprostol was given in 21%, 7% cases underwent laparotomy for rupture ectopic while one case needed only Blood Transfusion. Blood transfusion along with surgical intervention was needed in 17 % cases while broad spectrum antibiotics were needed in 15% cases of sepsis. One woman underwent hysterectomy following post-abortal sepsis with pyoperitoneum.
Conclusion: The results are an eye-opener. The over the counter availability of the abortion pill must be checked and focus should be made on counselling the women regarding the use of regular contraception practices.
Keywords: Over the counter, Self-prescription, MTP pill, Unsupervised medical abortion.