medical termination in first trimester and early and mid 2nd trimester

2. 1. Mifepristone
2. Mifepristone
200 mg orally on day1
3. Methotrexate
50 mg/m2 IM
(before 56days of gestation)
Misoprostol
400µg orally or,
800 µg vaginally on day3
7days latter
Misoprostol
800 µg vaginally

3. Surgical—
1.Menstrual Regulation-it is the aspiration of endometrial
cavity within 14days of missed period in a woman with previous normal cycle
2.Vacuum aspiration (MVA/EVA)-upto
12wk
3.Suction Evacuation and/or curettage-not
suitable of >10wk size uterus
4.Dilatation and Evacuation (i) Rapid
method (ii) Slow method

4. Misoprostol 800 µg Vaginally 3 hourly
Misoprostol 600 µg Vaginally 1st dose200 µg orally 3 hrly
Misoprostol 400 µg Sublingually 3 hrly , maxm 5 doses
(100% success)
Gemeprost (PGE1) 1 mg vaginal pessary every 3-6hrs, 5 doses in 24hr
Mifepristone 200 mg oral Miso 800 µg vaginal 36-48hrs later, miso
400µg every 3hr for 4 doses
(Pretreatment with Mifepristone ↓ induction-abortion interval)
Dinoprostone (PGE2) 20 mg vaginal suppository 3 hrly, 4 doses
Carboprost (PGF2α) 250 µg IM 3 hrly, 10 doses. C/I- Asthma
Oxytocin drip : High dose(upto 300units in 500ml dextrose saline) is favored

5. Between 13-15wk Dilatation and ecacuation with cervical
preparation(mifepristone or misoporstole)
Between 16-20 Intrauterine installation of hypertonic saline
*intra-amniotic * Extra-amniotic
Extra-amniotic: done transcervically
0.1%ethacryine lactate with Foleys cathether
10 ml/wk
Hysterotomy Prior failed MTP,D&E can’t be done, fibroid in LUS,
uterine anomalies, repeated scared uterus with placenta
accreta or percreta
In Rh –ve women after abortion IM ant-D ig within
72hr of abortion