Mifepristone- and misoprostol-induced mid-trimester termination of pregnancy: a review of 272 cases.
BACKGROUND
Mifepristone became available in New Zealand in 2001, and was first used for second trimester terminations at the Level J Unit, Wellington Hospital. The protocol is based on that published by Ashok et al. in Aberdeen.


OBJECTIVE
To describe the use of mifepristone prior to misoprostol induction of labour for mid-trimester termination and to compare outcomes with the published data.


METHODS
A retrospective audit of prospectively collected notes for 272 women presenting for mid-trimester termination of pregnancy in a hospital termination clinic. Data collection included age, ethnicity, previous pregnancies, gestational age, induction-to-abortion interval, analgesia, and complications. Data were entered into an Access database and imported into Excel and Epi Info for the computation of descriptive statistics.


RESULTS
Data on completed abortion were available for 271 women (one chose not to continue the abortion following mifepristone). The median time to abortion was 6 h, and mean number of doses of misoprostol was three. The proportion of women who aborted within 24 h was 95.9%. Immediate surgical evacuation of retained placenta was required in 22 women (8.1%). Heavy bleeding occurred in 22 women (8.1%), and seven required a transfusion (2.6%). The proportion of women who required parenteral narcotics was 78.2%.


CONCLUSIONS
Outcomes for women in the present review were comparable with those for previous publications using the same regimen, with the exception of a higher transfusion rate. Our experience supports the finding that the use of mifepristone as pretreatment to misoprostol results in a shorter induction-to-delivery interval than the use of misoprostol alone as has been reported by other groups.
Rose
Sally B
SB
Department of Primary Health Care and General Practice, Wellington School of Medicine and Health Sciences, and Level F Unit, Wellington Hospital, Capital and Coast Health Ltd., Wellington, New Zealand.
Shand
Carol
C
Simmons
Ann
A
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D000028:Abortion, Induced / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008485:Medical Audit; D015735:Mifepristone; D016595:Misoprostol; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone