title: Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days.
abstract: BACKGROUND
  From 2001 to March 2006, Planned Parenthood Federation of America (Planned Parenthood) health centers throughout the United States provided medical abortions principally by a regimen of oral mifepristone, followed 24-48 h later by vaginal misoprostol. In late March 2006, analyses of serious uterine infections following medical abortions led Planned Parenthood to change the route of misoprostol administration and to employ additional measures to minimize subsequent serious uterine infections. In August 2006, we conducted an extensive audit of medical abortions with the new buccal misoprostol regimen so that patients could be given accurate information about the success rate of the new regimen.
  
  
  OBJECTIVE
  We sought to evaluate the effectiveness of the buccal medical abortion regimen and to examine correlates of its success during routine service delivery.
  
  
  METHODS
  In 2006, audits were conducted in 10 large urban service points to estimate the success rates of the buccal regimen. Success was defined as medical abortion without vacuum aspiration. These audits also permitted estimates of success rates with oral misoprostol following mifepristone in a subset in which 98% of the subjects stemmed from two sites.
  
  
  RESULTS
  The effectiveness of the buccal misoprostol-mifepristone regimen was 98.3% for women with gestational ages below 60 days. The oral misoprostol-mifepristone regimen, used by 278 women with a gestational age below 50 days, had a success rate of 96.8%.
  
  
  CONCLUSIONS
  In conjunction with 200 mg of mifepristone, use of 800 mcg of buccal misoprostol up to 59 days of gestation is as effective as the use of 800 mcg of vaginal misoprostol up to 63 days of gestation.
authors.affiliation: Planned Parenthood Federation of America, New York, NY 10001, USA. fjerstadm@ipas.org
authors.forename: Mary
authors.initials: M
authors.lastname: Fjerstad
authors.forename: Irving
authors.initials: I
authors.lastname: Sivin
authors.forename: E Steve
authors.initials: ES
authors.lastname: Lichtenberg
authors.forename: James
authors.initials: J
authors.lastname: Trussell
authors.forename: Kelly
authors.initials: K
authors.lastname: Cleland
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cullins
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000278:Administration, Buccal; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D012189:Retrospective Studies; D014505:Urban Population; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone
references.citation: Contraception. 2005 Nov;72(5):328-32
references.pmid: 16246656
references.citation: Contraception. 2011 Nov;84(5):505-7
references.pmid: 22018125