TO EVALUATE OUTCOME AND COMPLICATIONS BETWEEN SUPERVISED AND UNSUPERVISED MEDICAL ABORTION PILL INTAKE

Introduction: Due to the easy access of medical abortion pill over the counter without medical consultation and despite guidelines and medical termination of pregnancy act, there is an increase in incidence of unsafe abortion, often leading to serious health complications.

Objective: To evaluate outcome and complications, socio-demographic factors that lead women to self administration of medical abortion pills and to assess awareness regarding use of medical abortion pills between supervised and unsupervised intake of medical abortion pills.

Methods: This prospective observational study was conducted between from June 2022 - June 2024, where a total of 600 patients were enrolled in the study. Patients were divided into two groups in which one group had supervised intake of MTP pills and other group had unsupervised intake of MTP pills. Their socio-demographic profile, indication of intake of MTP pill, source of drug, awareness about MTP pill or any other form of contraceptions, outcome and complications were evaluated.The data were encoded and entered into MS Excel spreadsheet application. Analysis was done using Origin pro software. Statistical analysis was done to analyse between the groups using percentage and Chi square test on categorical variables. The correlation between dependent and independent variables was evaluated using multivariate logistic regression.

Result: Insupervised group, majority (58.53%) were aged between 21-30 years of age, whereas in unsupervised group majority(61.33%) were aged between 31-40 years of age. It was observed that in both groups majority of patients belonged to middle economic status. It had been observed that majority(90.66%) of pregnancy in unsupervised group was diagnosed by UPT and with history of MTP pill intake between 9-12 weeks gestation(43.34%) leading to more complications, while in supervised intake, pregnancy was diagnosed by USG(99.66%)and termination of pregnancy was done before 9 weeks of gestation(72.67%) with minimal complications. Anaemia is the most common associated co-morbidity were severe anaemia was noted in 25% patients in unsupervised group compared to 15% in supervised group.In unsupervised group, 42.67% patients required suction and evacuation with blood transfusion with only 14% in supervised group.

Conclusion: It was observed that the magnitude of complications was more seen in unsupervised intake of MTP pill like need for blood transfusion, laparotomy, hysterectomy and maternal mortality. There is an urgent need of restricting the free availability of over the counter MTP pill and to educate and increase awareness about the complications of unsupervised MTP pill intake.