title: Medical abortion in the first trimester: the use of serum hCG and endometrial thickness as markers of completeness.
abstract: OBJECTIVE
  The combination of mifepristone and misoprostol is an established method for induction of early first trimester abortion, but there is no consensus about the best evaluation of treatment outcome. We assessed endometrial thickness, determined by ultrasound and serum-human chorionic gonadotropin (s-hCG) as markers of successful management.
  
  
  METHODS
  Prospective trial involving 255 women, with a gestation of 62 days or less, who were to undergo medical abortion. In addition to our established routines of performing clinical and ultrasound examinations, we also determined the s-hCG level prior to treatment and at follow-up.
  
  
  RESULTS
  Of the 255 subjects treated during the study, 20 (7.8%) were lost to follow-up. The overall complete abortion rate was 94.0%. Fourteen subjects required vacuum aspiration, nine of them prior to the scheduled follow-up and five thereafter. None of the pregnancies were ongoing. A decrease of 99% in s-hCG levels was noted in 99% of the women, when levels determined prior to mifepristone intake and those measured 15-71 days post-abortion were compared.
  
  
  CONCLUSIONS
  This study confirms that s-hCG levels drop sharply after medical abortion. To assess the completeness of medical abortion, we recommend that clinical examination to be combined with determination of s-hCG. Ultrasonography should be carried out only when indicated.
authors.affiliation: Institute of Clinical Medicine, Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Pooja
authors.initials: P
authors.lastname: Parashar
authors.forename: Ole Erik
authors.initials: OE
authors.lastname: Iversen
authors.forename: Grete
authors.initials: G
authors.lastname: Midbøe
authors.forename: Ole
authors.initials: O
authors.lastname: Myking
authors.forename: Line
authors.initials: L
authors.lastname: Bjørge
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods* / Q000592:standards*; D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D004717:Endometrium / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage; D016595:Misoprostol / Q000008:administration & dosage; D009664:Norway; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D006063:Chorionic Gonadotropin; D016595:Misoprostol; D015735:Mifepristone