Comparative Efficacy and Safety of Mifepristone Plus Misoprostol, Cerviprime Plus Misoprostol, and Misoprostol Alone in Mid-Trimester Pregnancy Termination: A Retrospective Observational Study

Abstract

ABSTRACT

Background: Mid-trimester abortions, accounting for a significant proportion of abortion-related morbidity and mortality, require effective and safe medical management. While several regimens are available, including Mifepristone plus Misoprostol, Cerviprime plus Misoprostol, and Misoprostol alone, their comparative efficacy and safety remain crucial for optimizing patient outcomes during this critical period of pregnancy termination.

Aim and Objective: To compare the efficacy and safety of three different medical regimens—Mifepristone plus Misoprostol, Cerviprime plus Misoprostol, and Misoprostol alone—for mid-trimester termination of pregnancy.

Materials and Methods: This retrospective observational study was conducted at a tertiary care centre's Department of Obstetrics and Gynecology from May 2014 to June 2015. A total of 45 women between 13 to 20 weeks of gestation who met the inclusion criteria were divided into three groups: Group A received Mifepristone plus Misoprostol, Group B received Cerviprime plus Misoprostol, and Group C received Misoprostol alone. The primary outcomes measured were the induction-abortion interval, the need for oxytocin augmentation, and the rate of complete abortion. Secondary outcomes included side effects such as fever, nausea, vomiting, and diarrhoea.

Results: Group A (Mifepristone plus Misoprostol) had the shortest mean induction-abortion interval of 6.2 hours, compared to 9.4 hours in Group B (Cerviprime plus Misoprostol) and 8.5 hours in Group C (Misoprostol alone). The complete abortion rate was highest in Group A at 93.3%, followed by Group C at 80% and Group B at 66.7%. The need for oxytocin augmentation was lowest in Group A (20%), compared to Group B (33.3%) and Group C (40%). Group B reported the highest incidence of side effects, including fever, nausea, and vomiting.

Conclusion: Mifepristone plus Misoprostol is the most effective and safe regimen for mid-trimester abortion among the methods studied, offering the shortest induction-abortion interval, the highest complete abortion rate, and fewer side effects. Cerviprime plus Misoprostol, while effective, is less practical due to its higher side effect profile and the need for refrigeration. Misoprostol alone, though effective, requires longer induction-abortion intervals and more frequent oxytocin augmentation, making it less favourable compared to the combination regimen.

Keywords: Mid-trimester abortion, Mifepristone, Misoprostol, Cerviprime, Induction-abortion interval, Oxytocin augmentation, Medical abortion safety.