Medical abortion for clinical practice

Abstract

Medical abortion is a safe, convenient, and effective method for terminating an early unintended pregnancy. Medical abortion can be performed up to 63 days from the last menstrual period and may even be used up to 70 days for women who prefer medical abortion over surgical abortion. Counseling on the adverse effects and expectations for medical abortion is critical to success. Medical abortion can be performed in a clinic without special equipment, and it is perceived as more "natural" than a surgical abortion by many women. Follow-up for medical abortion can be simplified to include only serum human chorionic gonadotropin measurements when necessary, although obtaining an ultrasound remains the criterion standard. Pain associated with medical abortion is best treated with nonsteroidal anti-inflammatory medications, possibly in combination with opioid analgesics. Medical abortion can contribute to continuity of care for women who wish to remain with their primary care providers for management of their abortion.

Comment: Medical abortion, with the use of mifepristone and misoprostol, is again mentioned as a safe, effective and convenient alternative to surgical abortion. It is important to tell women that, after the ingestion of mifepristone, it takes at least 24 hours, and often 48 hours, for the abortion to start. Thus avoiding an early, unnecessary intervention with manual vacuum aspiration. (HMV)