Monitoring medical abortion using mifepristone/misoprostol combination with ultrasonogram and serum human chorionic gonadotropin.
OBJECTIVE
The oral mifepristone/misoprostol combination (MMC) is safe for medical abortion in early pregnancy. The abortion status in MMC-treated pregnancies at Taipei Medical University-Wan Fang Medical Center was determined by ultrasonography, serum beta-human chorionic gonadotropin (beta-HCG), and histopathology.


METHODS
All women at less than 49 days since the last menstruation who asked for legal abortion were evaluated by ultrasonography. They then received 600 mg of oral mifepristone followed 48 hours later by 600 microg of misoprostol. Women who had vaginal spotting or bleeding after 14 days were included in this study and underwent transvaginal ultrasonography, serum beta-HCG measurement and vacuum aspiration or therapeutic dilatation and curettage (D&C) on day 14. Specimens were identified by histopathology. Abortion status was determined from linear regression of serum beta-HCG and endometrial thickness.


RESULTS
Of 35 women who underwent vacuum aspiration or therapeutic D&C, histopathology showed that 20 had decidual tissue and 15 had gestational tissue. Logistic regression showed that the distance measurement to the logistic regression line differed significantly between complete and incomplete abortion (p < 0.05).


CONCLUSIONS
In this study, serum beta-HCG assays in addition to ultrasonographic evaluation helped to discriminate abortion status after oral MMC.
Chou
Szu-Yuan
SY
Department of Obstetrics and Gynecology, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
Chen
Chih-Yen
CY
Chiang
Huihua Kenny
HK
Chow
Pui-Ki
PK
Wang
Ching-Chiung
CC
Hsu
Chun-Sen
CS
D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology*; D000021:Abortifacient Agents, Steroidal / Q000494:pharmacology*; D000027:Abortion, Incomplete / Q000097:blood / Q000000981:diagnostic imaging; D000028:Abortion, Induced; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016015:Logistic Models; D015735:Mifepristone / Q000494:pharmacology*; D016595:Misoprostol / Q000494:pharmacology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014463:Ultrasonography
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D006063:Chorionic Gonadotropin; D004338:Drug Combinations; D016595:Misoprostol; D015735:Mifepristone