A comparison of intravaginal misoprostol with extraamniotic ethacridine lactate for second trimester MTP

OBJECTIVE(S) : To compare safety, efficacy, complications, and cost effectiveness of extraamniotic instillation of ethacridine lactate with vaginal misoprostol for voluntary termination of second trimester pregnancy. METHOD(S) : A prospective comparative study on 120 pregnant women between 13 and 20 weeks was conducted from July 2004 to June 2005. Women were randomized in two groups. In one group extraamniotic ethacridine lactate (10mL/week of gestation) instillation was done and in the other, 400 ? g tablet of misoprostol was inserted in the vagina every 12 hours for a maximum of 4 doses. RESULTS : The rate of successful abortions within 48 hours was 95% (57/60 women) in each group. Among those who had aborted within 48 hours, the mean interval from induction to abortion was shorter in misoprostol group (15.5 hours vs 31.3 hours, P<0.0001). The rate of complete abortion, defined as expulsion of both fetus and placenta without operative assistance, was 66.6% for misoprostol and 70% for ethacridine lactate (P=0.344). The average cost per treatment was Rs. 57.95 for misoprostol as compared to Rs. 86.10 for ethacridine lactate. Side effects were uncommon and did not differ between the two groups. CONCLUSION(S) : Success rates of misoprostol and ethacridine lactate were comparable but the induction abortion interval was almost half in misoprostol group when compared with that in ethacridine lactate group.