Medical abortion. defining success and categorizing failures.
Medical abortion was performed in 461 consecutive women with gestational age </= 63 days using a regimen of mifepristone 600 mg followed 2 days later by gemeprost 1 mg vaginally. Success, defined as no surgical intervention, declined from 98.7% after 2 weeks to 94.6% after 15 weeks. The difference in short- and long-term success rates increased with increasing gestational age. The majority of failures (76%) were diagnosed more than 2 weeks after initiation of the abortion. At a 2-week follow-up visit, the women who turned out to be failures had a larger endometrial width, higher beta-hCG values and smaller reductions of beta-hCG than those treated successfully. To optimize comparison of success rates after different medical abortion regimens, we suggest that the criteria for success are stated clearly, that the success rates are stratified according to gestational age and that the indications for secondary intervention are categorized.
Rørbye
Christina
C
Department of Obstetrics and Gynecology, H:S Hvidovre Hospital, University of Copenhagen, Kettegaard Alle 30, 2650 Hvidovre, Denmark. christina.roerbye@hh.hosp.dk
Nørgaard
Mogens
M
Vestermark
Vibeke
V
Nilas
Lisbeth
L
D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods / Q000706:statistics & numerical data*; D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D017211:Treatment Failure
D000021:Abortifacient Agents, Steroidal; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil