Analysis of Complications and Management After Self-Administration of Medical Termination of Pregnancy Pills

Cureus. 2021 Nov 18;13(11):e19730. doi: 10.7759/cureus.19730. eCollection 2021 Nov.

Abstract

Background Medical abortion up to seven weeks of pregnancy by using a combination of mifepristone and misoprostol with careful follow-up is approved by WHO guidelines. But due to the counter sale of medical termination of pregnancy (MTP) pills, in our country, pregnant women have easy access to use them landing upon serious complications. The present study aims to assess the outcome of self-medicated MTP pills in pregnant women. Method This prospective observational study includes pregnant women who presented to our hospital for medical assistance due to complications after using the counter of MTP pills without medical consultation. Findings of ultra-sonographic and physical examination were noted along with analysis of subsequent management. Results The major complaint at presentation was excessive bleeding (78%). Out of 100 patients, 66% of cases were diagnosed as incomplete abortion, 6% as missed abortion, and 6% as unaffected pregnancy. Ectopic pregnancy was detected in 12% of cases. Sixty patients of incomplete abortion were managed with suction and evacuation and six were supplemented with misoprostol. All patients with ectopic pregnancies were managed surgically. Conclusion The majority of the pregnant women who took MTP pills presented with serious complications in the form of bleeding, incomplete/missed abortion, and ectopic pregnancy. Restriction of the over-the-counter dispensation of abortion pills needs to be strictly implemented and knowledge of women regarding the unfavourable outcome of MTP pill intake without proper consultation needs to be improved.

Keywords: abortion; complications; ectopic pregnancy; medical termination of pregnancy; suction curettage.