Early medical abortion with self-administered low-dose mifepristone in combination with misoprostol

Abstract

Aim: The aim of the present study was to investigate the safety and efficacy of low-dose mifepristone combined with self-administered misoprostol for termination of early pregnancy.

Methods: A total of 533 women seeking medical abortion in early pregnancy (=49 days since the last menstrual period) were divided randomly into hospital- (H-Mis, 250) and self- (S-Mis, 283) administered misoprostol groups. Women in two groups took 100mg of oral mifepristone in hospital followed by 200μg of sublingual misoprostol 24h later in hospital or home. The primary outcome parameter was complete abortion without surgical intervention. Secondary outcomes were uterine bleeding, return of regular menses, side effects and patient acceptability.

Results: High rates of complete abortion were observed for both the H-Mis group (243/250; 94.8%) and the S-Mis group (266/283; 94.0%). No significant differences in outcomes (complete abortion/failure rates) or side effects were observed between the two groups. General satisfaction rates were similar for the two groups (H-Mis, 231/250, 92.4%; S-Mis, 263/283, 92.9%; P>0.05). Higher convenience of administration (H-Mis, 211/250, 84.4%; S-Mis, 270/283, 95.4%; P<0.05) and privacy protection (H-Mis, 214/250, 85.6%; S-Mis, 267/283, 94.3%; P<0.05) satisfaction rates were obtained for the S-Mis group than for the H-Mis group.

Conclusion: Self-administered sublingual misoprostol is as safe and effective as hospital-administered misoprostol following low-dose mifepristone to terminate early pregnancy (=49 days of amenorrhoea) with fewer side effects.

Comment: Again a nice paper which shows that safe medical abortion can be performed at home, without the need to return to hospital for the misoprostol administration. (HMV)