Background Mifepristone and a prostaglandin have been used successfullyto terminate pregnancy in Europe and China. We report the resultsof a large U.S. study of mifepristone and misoprostol in womenwith pregnancies of up to nine weeks' duration.
Methods We administered 600 mg of mifepristone and then 400µg of misoprostol two days later to 2121 women seekingtermination of their pregnancies at 17 centers. The women wereobserved for four hours after the administration of misoprostoland returned on day 15 for final assessment.
Results Two thousand fifteen women completed the final assessment.Among them, pregnancy was terminated in 762 of the 827 womenpregnant for <49 days (92 percent), 563 of the 678 womenpregnant for 50 to 56 days (83 percent), and 395 of the 510women pregnant for 57 to 63 days (77 percent) (P<0.001).Termination occurred within 4 hours after the administrationof misoprostol in 49 percent of the women and within 24 hoursin 75 percent. Failures, defined as cases requiring surgicalintervention for medical reasons or because the patient requestedit, the abortion was incomplete, or the pregnancy was ongoing,increased with increasing duration of pregnancy. The largestincrease was in failures representing ongoing pregnancy, whichincreased from 1 percent in the <49-days group to 9 percentin the 57-to-63-days group (P<0.001). Abdominal pain, nausea,vomiting, diarrhea, and vaginal bleeding also increased withadvancing gestational age. Two percent of the women in the <49-daysgroup, as compared with 4 percent in each of the other two groups,were hospitalized, underwent surgical intervention, and receivedintravenous fluids (P = 0.008).
Conclusions This mifepristone–misoprostol regimen is effectivein terminating pregnancies, especially in women with pregnanciesof 49 days' duration or less.
Source Information
The principal investigators and centers participating in the study are listed in the Appendix.
From the Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY 10021, where reprint requests should be addressed to Dr. Robbins.
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