Neelima Agarwal

Abstract

Introduction: Medical termination of pregnancy (MTP), despite legalization, is a greatly neglected health care problem of women in their reproductive age group and is not free from complications. Therefore, the present study was undertaken to study the factors influencing MTPs & the subsequent adoption of contraceptive methods following MTP. Materials and Methods: This cross-sectional study was conducted over one year and included 148 women who underwent MTP at the hospital. The details regarding their socio-demographic profile, reason for seeking abortion and acceptance of post abortal contraception were taken and analyzed by SPSS software. Results: Majority of women (93.92%) were aware of the various contraceptive methods available and awareness was maximum for condom (87.16%). The main source of information was television (76.35%). 85.81% women had no knowledge about emergency contraception. 89.20% patients came early for termination of pregnancy below 8 weeks. Completed family was the most common reason (62.84%). Post abortion contraception was accepted by 92.56% women. IUCD was the most preferred choice (51.35%). Decision regarding contraception was taken by both husband and wife in 45.95% cases. Conclusions: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth and it is not free from risk. Eligible couples have to be educated regarding the availability of different methods of contraception and their proper use to avoid pregnancy. Keywords: Medical termination of pregnancy, MTP seekers, Socio demographic profile, Post abortion contraception, Emergency contraception, Eligible couples.

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Abstract

Introduction: Missed abortion is a type of abortion in which the dead fetus is retained within the uterus. The objective of the study was to find out whether the use of one or two doses of 800 µg misoprostol alone, administered intra-vaginally, is effective and safe in termination of missed abortion up to 20 weeks of pregnancy. Materials and Methods: This Interventional study was conducted in a tertiary care hospital, for a period of 12 months. Sample size consisted of 67 cases of missed abortion up to 20 weeks of pregnancy which was confirmed by ultrasound. These patients were given 800µg misoprostol and were followed up for successful termination of pregnancy and side effects, viz., pain, excessive bleeding, need for surgical evacuation, rupture uterus and infection. If complete abortion had not been attained by a single dose, a repeat dose of 800µg vaginal misoprostol was inserted. Results: In the present study, 88.06% patients aborted completely after giving misoprostol alone; where as 72.9% patients requiring only single dose of misoprostol. The success rate decreased with increasing parity and number of previous abortions in patients and results were found statistically significant (p = 0.008 and 0.035 respectively). Side effects were tolerable and required only proper counseling. Conclusion: Misoprostol alone is a safe and effective method of termination of missed abortion up to 20 weeks of gestation; and will prove to be a good alternative to surgical management.     Keywords: Missed abortion, Misoprostol, Intra-vaginally, Termination of pregnancy, 20 weeks gestation, Surgical evacuation.

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