Early pregnancy termination with mifepristone and misoprostol in the United States.

ABSTRACT

PIP: The availability of medical abortion in the US and elsewhere could lead to greater access to safer abortion services. This study assessed the capability of mifepristone (600 mg) and misoprostol (400 mcg 2 days later) to terminate pregnancies of up to 63 days' duration. Enrolled were 2121 US women recruited from 17 Planned Parenthood, university hospital, and free-standing abortion clinics. Among the 2015 women who returned for the follow-up visit at day 15, the rates of pregnancy termination were 92% in women with pregnancies of durations of 49 days or under, 83% in the 50-56 days group, and 77% in the 57-63 days group (p 0.001). Abortion occurred within 4 hours of misoprostol administration in 49% of women and within 24 hours in 75%. Termination rates were higher for women with no previous induced abortions. Side effects such as abdominal pain, nausea, vomiting, diarrhea, and vaginal bleeding were frequent and increased with gestational age. 2% of women with pregnancies of 49 days' gestation or less, compared with 4% in both the 50-56 days and 57-63 days groups, were hospitalized, underwent surgical intervention, and received intravenous fluids. The success rate in this study was lower than that reported by other researchers. This may be related, in part, to the lack of experience with medical abortion in the US.