Pregnancy Termination: What are the chances of a medical termination failing?

Authors

Ashok PW. Templeton A.

Institution:

Dr. P.W. Ashok, Department of Obstetrics Gynaecology, University of Aberdeen,

Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZD; United

Kingdom.

Title:

Nonsurgical mid-trimester termination of pregnancy: A review of 500 consecutive cases. (1999 2713)

Source:

British Journal of Obstetrics and Gynaecology. Vol 106(7) (pp06-710), 1999.

Abstract:

Objective. To assess the effectiveness of a regimen comprising mifepristone followed by a combination of the vaginal and oral administration of misoprostol for mid-trimester medical termination of pregnancy. Design. Retrospective analysis of prospectively collected data in women undergoing mid-trimester medical termination of pregnancy. Setting. Aberdeen Royal Infirmary, Scotland. Sample. A consecutive series of 500 women with pregnancies of 13-21 weeks of amenorrhea undergoing legally induced abortion in one Scottish NHS hospital. Methods. Each woman received a single oral dose of mifepristone 200 mg and 36-48 h later vaginal misoprostol 800 mug. Three hours following the first dose of misoprostol, 400 mug doses were administered orally at three hourly intervals, to a maximum of four doses. Success was defined as abortion occurring with five doses of prostaglandin, or within 15 h of administration of the first dose of prostaglandin.

Results:

Ninety-seven percent aborted successfully. The median dose of misoprostol required was 1200 mug and the median induction-to-abortion interval after first prostaglandin administration was 6.5 h. The median number of doses of misoprostol required to induce abortion, and the induction-to-abortion interval, was statistically significantly higher among women at gestations 17-21 weeks than among those at 13-16 weeks (P = 0.0001). A total of 9.4% required surgical evacuation of the uterus under general anaesthesia and 66.4% of the women were managed as day cases. Conclusions. The combination of oral mifepristone 200 mg followed by vaginally and orally administered misoprostol provides a noninvasive and effective regimen for second trimester termination of pregnancy.

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