Medical abortion at 9-13 weeks' gestation: a review of 1076 consecutive cases.
OBJECTIVE
The aim of the study was to assess the use, efficacy and factors influencing the outcome of medical abortion at 9-13 weeks' gestation.


METHODS
Retrospective chart review of consecutive women undergoing medical abortion at 9-13 weeks' gestation was done.


RESULTS
A total of 1927 abortions were carried out at 9-13 weeks' gestation, of which 1076 (55.8%) were undertaken medically. Efficacy decreased with increasing gestation (p=.02). Surgical evacuation was carried out in 45 (4.2%) women including 10 (2.7%) at 64-70 days, 11 (3.3%) at 71-77 days, 10 (5.1%) at 78-84 days and 14 (8.0%) at 85-91 days of gestation (p=.02). Indications for surgery included continuing pregnancy [16 (1.5%) women], retained sac [5 (0.5%)], incomplete abortion [20 (1.9%)] and emergency curettage for bleeding [4 (0.4%)]. The number of misoprostol doses used and the induction-to-abortion interval both significantly increased with gestation (p<.001), while analgesia requirements did not vary with increasing gestation (p=.18).


CONCLUSIONS
Medical abortion at 9-13 weeks' gestation is an effective alternative to surgery. Medical methods should be offered routinely at these gestations, thus increasing women's choice.
Hamoda
Haitham
H
Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, AB25 2ZD Aberdeen, UK. ogy262@abdn.ac.uk
Ashok
Premila W
PW
Flett
Gillian M M
GM
Templeton
Allan
A
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000030:Abortion, Missed / Q000453:epidemiology / Q000601:surgery; D000282:Administration, Intravaginal; D000328:Adult; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D004338:Drug Combinations; D016595:Misoprostol; D015735:Mifepristone