title: Significant adverse events and outcomes after medical abortion.
abstract: OBJECTIVE
  To analyze rates of significant adverse events and outcomes in women having a medical abortion at Planned Parenthood health centers in 2009 and 2010 and to identify changes in the rates of adverse events and outcomes between the 2 years.
  
  
  METHODS
  In this database review we analyzed data from Planned Parenthood affiliates that provided medical abortion in 2009 and 2010 almost exclusively using an evidence-based buccal misoprostol regimen. We evaluated the incidence of six clinically significant adverse events (hospital admission, blood transfusion, emergency department treatment, intravenous antibiotics administration, infection, and death) and two significant outcomes (ongoing pregnancy and ectopic pregnancy diagnosed after medical abortion treatment was initiated). We calculated an overall rate as well as rates for each event and identified changes between the 2 years.
  
  
  RESULTS
  Among 233,805 medical abortions provided in 2009 and 2010, significant adverse events or outcomes were reported in 1,530 cases (0.65%). There was no statistically significant difference in overall rates between years. The most common significant outcome was ongoing intrauterine pregnancy (0.50%); significant adverse events occurred in 0.16% of cases. One patient death occurred as a result of an undiagnosed ectopic pregnancy. Only rates for emergency department treatment and blood transfusion differed by year and were slightly higher in 2010.
  
  
  CONCLUSIONS
  Review of this large data set reinforces the safety of the evidence-based medical abortion regimen.
  
  
  METHODS
  III.
authors.affiliation: Office of Population Research, Princeton University, Princeton, New Jersey 08648, USA. kcleland@princeton.edu
authors.forename: Kelly
authors.initials: K
authors.lastname: Cleland
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Creinin
authors.forename: Deborah
authors.initials: D
authors.lastname: Nucatola
authors.forename: Montsine
authors.initials: M
authors.lastname: Nshom
authors.forename: James
authors.initials: J
authors.lastname: Trussell
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects; D000027:Abortion, Incomplete / Q000139:chemically induced / Q000453:epidemiology; D000028:Abortion, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003141:Communicable Diseases / Q000453:epidemiology; D004638:Emergency Treatment / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D015735:Mifepristone / Q000009:adverse effects; D016595:Misoprostol / Q000009:adverse effects; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000900:Anti-Bacterial Agents; D016595:Misoprostol; D015735:Mifepristone