Tunisia: Two medical abortion regimens for late first-trimester termination of pregnancy

The authors concluded that for late first-trimester termination, a single 800-mcg vaginal dose of misoprostol seems to be as effective as the mifepristone+misoprostol regimen, with acceptable side effects. From Contraception. 

The authors noted that medical abortion regimens based on the use of either misoprostol alone or in association with mifepristone have shown high efficacy and excellent safety profile in early pregnancy abortion. However, no clear recommendation is available for late first-trimester termination of pregnancy.

This was a prospective randomized controlled trial included 122 women seeking medical abortion at 9 to 12 weeks of gestation. Seventy-three patients were given a fixed protocol of 200 mg of mifepristone followed 48 h later by 400 mcg oral misoprostol (Group 1). The second group of 49 patients was administered 800-mcg intravaginal single-dose misoprostol (Group 2). This study sought to compare safety, efficacy and acceptability of these two nonsurgical abortion regimens.

The results found that 59 (80.8%) women in Group 1 had complete abortion vs. 38 (77.4%) women in Group 2 (p=.66). Abdominal pain was observed significantly more often in Group 2 (35/49 (71.4%) vs. 32/73 (43.8%) in Group 1, p<.0001. Medical abortion was equally acceptable among the two groups [37/49 (75.5%) and 55/73 (75.7%), p=.89].

The authors concluded that for late first-trimester termination, a single 800-mcg vaginal dose of misoprostol seems to be as effective as the mifepristone+misoprostol regimen, with acceptable side effects.

Department A of Obstetrics and Gynecology, Tunisian Maternity and Neonatology Center, Rabta, Tunis, Tunisia.

Two medical abortion regimens for late first-trimester termination of pregnancy: a prospective randomized trial. Dalenda C, Ines N, Fathia B, Malika A, Bechir Z, Ezzeddine S, Hela C, Badis CM. Contraception. 2010 Apr;81(4):323-7. Epub 2010 Jan 15.