Contraception. 2016 Jul 25.

Medical abortion in women with large uterine fibroids: a case series

Mark K, Bragg B, Chawla K and Hladky K


Women with fibroid uteri seeking surgical abortion often represent a unique challenge. When the uterine cavity is significantly enlarged or distorted making surgical evacuation difficult or impossible, we offer medical abortion using mifepristone followed by misoprostol beyond the standard 63 to 70 day gestational age cut off that is typically recommended. This case series describes our regimen and outcomes for 6 patients from 10 to 13 weeks' gestation undergoing outpatient medical abortion and 6 patients from 14 to 20 weeks' gestation undergoing inpatient medical abortion. Three patients required evacuation for retained products and all others had successful medical abortions without complications.

Comment: From time to time we get a request for an abortion from a woman with fibroids. This paper can be helpful in putting these women at ease: even with large uterine fibroids most women had a uneventful abortion. However, owing to the sometimes abnormal shape of the uterine cavum, one should be extra vigilant for retained tissue. (HMV)