Case control study of supervised and unsupervised medical abortions in first trimester of pregnancy at a tertiary care center.

Background: Abortion service as medical healthcare facility is an essential service a women needs. The objective of this study was to observe maternal outcome of supervised and unsupervised medical abortion in first trimester of pregnancy. Methods: A case control study was done with two groups of patients in their first trimester in a tertiary care hospital (SMGS) during a period of 1 year from July 2022 to July 2023.Case group includes 30 patients presenting to emergency department with history of unsupervised abortion pill intake. Control group consists of 30 patients presenting to OPD want abortion pill under supervision. The main outcome variables were comparison of success rate, complications like heavy bleeding, fever, shock, requirement of blood transfusion and interventions required in terms of medical management, surgical evacuations and Laparotomy. Results: In our study, the success rate achieved in terms of complete abortion was 76.7% in supervised group and 13.3% in unsupervised group. The complication rate was 23.3% in supervised group in contrast to 93.3% in the unsupervised group. 43.3% patients in unsupervised group required blood transfusion which was 10% in supervised group. 83.3% in the supervised group did not require intervention. In the unsupervised group 20% required medical management, 70% required surgical evacuations and 10 % had to undergo Laparotomy for ectopic pregnancy. Conclusion: In this study, we conclude that first trimester medical abortion under supervision is more effective and safe as compared to unsupervised medical abortion. Thus we recommend to curb the practice of over the counter sale of medical abortion pills. [ABSTRACT FROM AUTHOR]