Verifying the effectiveness of medical abortion; ultrasound versus hCG testing.
OBJECTIVE
The combination of mifepristone and misoprostol is an established method for termination of pregnancy. However, there is no general agreement about how best to evaluate the treatment outcome.


METHODS
In 217 women with an unwanted pregnancy below 49 days of amenorrhoea, ultrasound examination and serum hCG test were performed before treatment and at follow-up.


RESULTS
Treatment was successful in 98.2%. At follow-up their hCG dropped to a mean of 3% (S.D. 3) of initial levels and the endometrium measured a mean of 10 mm (S.D. 4). Interpretation of endometrium was difficult in some cases because of inhomogeneous structure. Using hCG was reliable in 98.5% of successful abortions. For ultrasound the corresponding figure was 89.8% for the cases with a confirmed intrauterine pregnancy before treatment but only 66% if all pregnancies were included.


CONCLUSIONS
Measuring serum hCG before treatment and at follow-up is more effective than ultrasound to confirm a successful medically induced abortion in early pregnancy.
Fiala
Christian
C
Department of Obstetrics and Gynecology, General Public Hospital, Wiener Ring 3-5, 2100 Korneuburg, Austria.
Safar
Peter
P
Bygdeman
Marc
M
Gemzell-Danielsson
Kristina
K
D000019:Abortifacient Agents / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D006063:Chorionic Gonadotropin / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015735:Mifepristone / Q000627:therapeutic use*; D016595:Misoprostol / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D016896:Treatment Outcome; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging*
D000019:Abortifacient Agents; D006063:Chorionic Gonadotropin; D016595:Misoprostol; D015735:Mifepristone