Effectiveness of Anti-Inflammatory Drugs for Preventing Pain Versus Treating Pain During Medical Abortion From 13 to 22 Weeks at Hung Vuong Hospital

Effectiveness of Proactive Versus On-Demand Pain Relief With Non-Steroidal Anti-Inflammatory Drugs During Medical Abortion at 13 to 22 Weeks at Hung Vuong Hospital

The goal of this clinical trial is to assess the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for prophylactic pain relief compared to on-demand pain relief during medical abortion for pregnancies between 13 and 22 weeks at Hung Vuong Hospital in Ho Chi Minh City. The main questions it aims to answer are:

1. Does prophylactic use of NSAIDs reduce pain compared to on-demand use during medical abortion?
2. What are the potential adverse effects of NSAIDs in this context?

Researchers will compare a group receiving prophylactic NSAIDs to a control group receiving on-demand pain relief to determine if the prophylactic approach leads to improved pain management outcomes.

Participants will:

• Be given NSAIDs either as a preventative measure or upon the onset of pain.
• Be monitored for pain levels using validated pain scales, any side effects, and outcomes of the abortion procedure.

Inclusion Criteria:

• Pregnant women aged 18 years or older.
• No mental illness.
• Gestational age between 13 and 22 weeks (based on the last menstrual period with a regular menstrual cycle and accurate recall of the last menstrual period, or based on a first-trimester ultrasound) with an indication of stillbirth, fetal malformation requiring termination, or voluntary abortion with counseling and understanding of the abortion procedure.
• Willing to participate in the study.
• Capable of reading and signing the informed consent form.
• Able to provide personal information independently.

Exclusion Criteria:

• Medical conditions contraindicating medical abortion: bleeding disorders, anticoagulant use, moderate to severe anemia.
• Cardiovascular conditions: heart failure, mitral valve stenosis, embolism, uncontrolled hypertension.
• Other medical conditions: renal failure, adrenal gland disorders, severe asthma, liver and biliary diseases, glaucoma.
• Active pelvic inflammatory disease or acute genital infections.
• Previous uterine surgery.
• Placenta previa or central placenta previa.
• Uterine malformations.
• History of allergy to NSAIDs, Mifepristone, or Misoprostol.
• Unwillingness to participate in the study.