Factors behind failure of unsupervised self induced medical abortion : A Study from North India


Methodology

Authors


  • Archana Mishra


    Associate Professor
    Department of Obstetrics and Gynaecology,
    Vardhman Mahavir Medical College and Safdarjung Hospital
    South Delhi, Delhi -110029

  • Sunita Malik


    Professor,
    Department of Obstetrics and Gynaecology,
    Vardhman Mahavir Medical College and Safdarjung Hospital
    South Delhi, Delhi -110029

  • Rupali Dewan


    Professor,
    Department of Obstetrics and Gynaecology,
    Vardhman Mahavir Medical College and Safdarjung Hospital
    South Delhi, Delhi -110029

  • Swati Gupta


    Senior Resident
    Department of Obstetrics and Gynaecology
    Vardhman Mahavir Medical College and Safdarjung Hospital
    South Delhi, Delhi -110029

  • Ruchi Hooda


    Senior Resident,
    Department of Obstetrics and Gynaecology,
    Vardhman Mahavir Medical College and Safdarjung Hospital
    South Delhi, Delhi -110029

DOI:

https://doi.org/10.7439/ijpr.v7i6.4163

Abstract

Introduction : Unsafe abortions contribute to 8% of maternal mortality. Easy availability and rampant use of medical methods of abortion lead to upsurge in self induced abortion related complications. Present study was conducted to assess the profile, knowledge, attitude and reasons of preference of self induced abortion in women visiting our centre after complication or failure of medical abortion. We also tried to evaluate the burden of different complications and factors behind failure of self induced medical abortion. Material and Methods: It was a prospective mixed methods study performed in the department of obstetrics and gynaecology at a tertiary care centre. These women were interviewed by two doctors with the help of pre structured questionainare and their diagnosis, course of management and duration of stay in the hospital was noted down from hospital records. Results: We recruited 216 women visiting our facility after some complication of self induced medical abortion. 92 women used Mifepristone and misoprostol regimen and rest used misoprostol. 165 women have purchased drugs over the counter from pharmacists. Major source of information is husband or friends. Most of the patients [n= 87.9%] consider it low risk.97% patients follow incorrect drug schedule and misoprostol was taken by oral route only. Ruptured ectopic pregnancy, anaemia, Sepsis, Incomplete abortion, Missed abortion and continuation of pregnancy was observed in 1.8%, 69.44%, 8.3%, 68.5 %, 9.7% and 23.14%. Conclusion: Neglect of eligibility criteria and faulty drug regimens are the most common reasons for failure on self induced medical abortions. Low perceived risk and reluctance to hospital visit and interventions are most common reasons of preference of self induced abortions.

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Author Biography

Archana Mishra, Associate Professor
Department of Obstetrics and Gynaecology,
Vardhman Mahavir Medical College and Safdarjung Hospital
South Delhi, Delhi -110029

Assistant Professor,

Department of Obstetrics and Gynaecology,

References

. World Health Organisation, Unsafe abortion, Global and Regional estimates of incidence of unsafe abortion and associated mortality in 2000. 4 th ed . Geneva. Switzerland: World Health organization, 2004.

. Grimes D. Benson J. Singh S. et al. Unsafe abortion : the preventable pandemic . Lancet 2006 ; 368: 1908-1919

. world.time.com/2013/07/…/world-population-focus-on-india-part-2-unsafe-abortions/

. Lichtenberg, Steve, Grimes, David and Paul, Maureen. A Clinician’s Guide to Medical and Surgical Abortion. s.l. : A Churchill Livingstone title, 1999. ISBN # 0-443-07529-8.

. Winikoff, Beverly, Ellerston, Charlotte and Clark, Shelley. Analysis of failure in medical abortion, Contraception, 54: 323-327.

. Creinin, Mitchell D. Current Medical Abortion Care, Current Women’s Health Reports, 3(6): 461-9.

. U.S. Department of Health & Human Services. Drugs@FDA, Mifeprex (mifepristone) Label and Approval History. FDA, U.S. Food and Drug Administration. [Online] April 27, 2009. [Cited: July 12, 2011.] http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020687s015lbl.pdf

. Spitz, Irving, et al., et al. Early Pregnancy Termination with Mifepristone and Misoprostol in the United States, The New England Journal of Medicine 1998; 338:1241-1247.

. U.S. Department of Health & Human Services. Drugs@FDA, Mifeprex (mifepristone) Label and Approval History. FDA, U.S. Food and Drug Administration. [Online] April 27, 2009. [Cited: July 12, 2011.] http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020687s015lbl.pdf.

. National Abortion Federation. A Provider’s Guide to Medical Abortion, Complications of Medical Abortion. National Abortion Federation, Early Options, [Online] 2010. [Cited: August 2, 2011.] http://www.prochoice.org/education/cme/online_cme/m2complications.asp.

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Published

2017-06-28

How to Cite

1.
Mishra A, Malik S, Dewan R, Gupta S, Hooda R. . Int J of Pharmc Res [Internet]. 2017 Jun. 28 [cited 2022 Oct. 25];7(6):123-6. Available from: https://ssjournals.net/index.php/ijpr/article/view/4163

Issue

Vol. 7 No. 6 (2017): Jun

Section

Research Articles

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