A Comparative Analysis of Two Distinct Dosing Intervals of Mifepristone and Misoprostol for Second Trimester Medical Termination of Pregnancy: A Randomized Controlled Trial (Code-T0190)

Introduction: Medical termination of pregnancy in the second trimester is a commonly performed procedure using mifepristone followed by misoprostol. The efficacy and safety of varying the dosing intervals between these drugs are not universally established, leading to the need for a comparative study. This randomized controlled trial assesses two distinct dosing intervals of mifepristone and misoprostol to determine the optimal regimen for second trimester medical termination of pregnancy.

Aims and Objectives:

1. To compare the efficacy of two distinct dosing intervals of mifepristone and misoprostol for Medical Termination of Pregnancy (MTP) in patients with a gestational age between 12+0 weeks and 23+6 weeks, focusing on:

• The induction-to-abortion interval
• The success rate and completeness of the abortion
• The number of misoprostol doses required

• Complications such as excessive hemorrhage and the necessity for surgical evacuation
• Side effects including nausea, vomiting, diarrhea, and fever

Methods: In this randomized controlled trial, 250 women in their second trimester of pregnancy were enrolled and randomly assigned to two groups: one group received mifepristone followed by misoprostol after a 24-hour interval, while the other group received the same drugs with a 48-hour interval. Primary outcomes included the success rate of abortion, and secondary outcomes assessed adverse effects, complications, and the requirement for surgical intervention.

Results: The group with the 48-hour interval showed a significantly higher success rate, fewer side effects, and a reduced need for surgical intervention. The 24-hour dosing interval was associated with an increased incidence of gastrointestinal issues and bleeding complications.

Conclusion: A 48-hour dosing interval between mifepristone and misoprostol is more effective and safer for second trimester medical termination of pregnancy compared to a 24-hour interval.

Keywords: Mifepristone, Misoprostol, Second trimester, Medical termination, Dosing intervals, Randomized controlled trial.