title: Medical abortion at 63 to 90 days of gestation.
abstract: OBJECTIVE
  To evaluate medical abortion as a treatment alternative for late first-trimester abortions and to evaluate the decrease in beta-hCG after abortion at 63-90 days of gestation.
  
  
  METHODS
  All women received mifepristone 200 mg orally, followed by 800 micrograms misoprostol vaginally 48 hours later. Misoprostol was repeated every 3 hours orally, to a maximum of five doses if needed. A clinical examination including ultrasonography was performed 8-14 days after treatment. beta-hCG level was determined before treatment and at follow-up.
  
  
  RESULTS
  A total of 254 pregnant women with gestational age 63 to 90 days were included. The successful termination rate was 91.7%. Surgical evacuation was carried out in 21 (8.3%) women. Most women (91.0%) found the method of treatment highly acceptable. The beta-hCG levels of women with successful termination had decreased more than 97.5% at follow-up.
  
  
  CONCLUSIONS
  Medical abortion is an effective and acceptable method for termination of pregnancy in late first trimester.
authors.affiliation: From the Department of Obstetrics and Gynecology, Haukeland University Hospital; and Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Løkeland
authors.forename: O E
authors.initials: OE
authors.lastname: Iversen
authors.forename: G S
authors.initials: GS
authors.lastname: Dahle
authors.forename: M H
authors.initials: MH
authors.lastname: Nappen
authors.forename: L
authors.initials: L
authors.lastname: Ertzeid
authors.forename: L
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*; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D016595:Misoprostol; D015735:Mifepristone
references.citation: Lalitkumar S, Bygdeman M, Gemzell-Danielsson K. Mid-trimester induced abortion: a review. Hum Reprod Update 2007;13:37–52.
references.citation: Ashok PW, Flett GM, Templeton A. Termination of pregnancy at 9–13 weeks' amenorrhoea with mifepristone and misoprostol. Lancet 1998;352:542–3.
references.citation: Hamoda H, Ashok PW, Flett GM, Templeton A. Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases. Am J Obstet Gynecol 2003;188:1315–9.
references.citation: Hamoda H, Ashok PW, Flett GM, Templeton A. Medical abortion at 9–13 weeks' gestation: a review of 1076 consecutive cases. Contraception 2005;71:327–32.
references.citation: Bracken H, Ngoc NT, Schaff E, Coyaji K, Ambardekar S, Westheimer E, et al. Mifepristone followed in 24 hours to 48 hours by misoprostol for late first-trimester abortion. Obstet Gynecol 2007;109:895–901.
references.citation: Largeaud M, El Guindi W, Perotti F, Montoya Y, Carles G, Seve B. [Medical termination of pregnancy at 9–14 weeks gestation. Prospective study of 105 cases in Saint-Laurent-du-Maroni (French Guyana)]. J Gynecol Obstet Biol Reprod (Paris) 2004;33:119–24.
references.citation: Carbonell Esteve JL, Varela L, Velazco A, Cabezas E, Tanda R, Sánchez C. Vaginal misoprostol for late first trimester abortion. Contraception 1998;57:329–33.
references.citation: Carbonell JL, Varela L, Velazco A, Tanda R, Sánchez C. Vaginal misoprostol for abortion at 10–13 weeks' gestation. Eur J Contracept Reprod Health Care 1999;4:35–40.
references.citation: Robinson HP, Fleming JE. A critical evaluation of sonar “crown-rump length” measurements. Br J Obstet Gynaecol 1975;82:702–10.
references.citation: Ashok PW, Templeton A, Wagaarachchi PT, Flett GM. Midtrimester medical termination of pregnancy: a review of 1002 consecutive cases. Contraception 2004;69:51–8.
references.citation: Christin-Maitre S, Bouchard P, Spitz IM. Medical termination of pregnancy. N Engl J Med 2000;342:946–56.
references.citation: Fiala C, Safar P, Bygdeman M, Gemzell-Danielsson K. Verifying the effectiveness of medical abortion; ultrasound versus hCG testing. Eur J Obstet Gynecol Reprod Biol 2003;109:190–5.
references.citation: Parashar P, Iversen OE, Midboe G, Myking O, Bjorge L. Medical abortion in the first trimester: The use of serum hCG and endometrial thickness as markers of completeness. Eur J Contracept Reprod Health Care 2007:1–6.
references.citation: Berer M. Medical abortion: issues of choice and acceptability. Reprod Health Matters 2005;13:25–34.
references.citation: Henshaw RC, Naji SA, Russell IT, Templeton AA. Comparison of medical abortion with surgical vacuum aspiration: women's preferences and acceptability of treatment. BMJ 1993 18;307:714–7.