[Trends in therapeutic abortion management from 1986 to 1994].
OBJECTIVE
This study was performed in order to evaluate indications, techniques and maternal risks of medical abortions, and technical difficulties encountered in these procedures.


METHODS
A monocentric, descriptive and retrospective study.


METHODS
Four hundred seventeen medical abortions (MA) were performed in our fetal medicine Unit between 1986 and 1994, including 117 (28%) performed for maternal reasons and 300 (72%) for fetal reasons. Each indication was discussed in a collegial system and varied protocols of labor induction were used, mainly prostaglandins, RU 486, or feticide. MAIN PARAMETERS MEASURED: They were duration of the labor, maternal accidents, number of the fetal post-mortem examinations, counselling given to the couples. We considered that a MA is correctly managed when the intervention corresponded to the following criteria: expulsion by natural route without uterine damage, an examinable fetus and examination by a foetopathologist.


RESULTS
Mean rate of MA satisfying our definition was about 45% in 1988 and reached to 74% in 1994. Our results show that the procedure is rarely complicated and that vaginal expulsion can be obtained. The foetopathologist examination rate increased regularly over the period. The mean gestational age of MA due to maternal indications was 14.5 weeks vs 23.9 weeks when dealing with fetal indications. The infection rate is about 6.2%, hemorrhage rate following expulsion was about 5.9% and the rate of uterine rupture was about 0.48%.


CONCLUSIONS
These data suggest that medical abortion need to be evaluated regularly.
Zimbris
L
L
Unité de Médecine Foetale, Fédération des Services de Gynécologie-Obstétrique de Montpellier, Hôpital Arnaud-de-Villeneuve.
Boulot
P
P
Giacalone
P L
PL
Hoffet
M
M
Sarda
P
P
Molénat
F
F
Toubin
R M
RM
Marès
P
P
D000032:Abortion, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D000293:Adolescent; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007239:Infections / Q000209:etiology; D007902:Length of Stay; D008875:Middle Aged; D018579:Patient Selection; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014592:Uterine Hemorrhage / Q000209:etiology; D014597:Uterine Rupture / Q000209:etiology
Prise en charge des interruptions médicales de grossesse. Evolution de 1986 à 1994.