title: Pain during medical abortion: a multicenter study in France.
abstract: OBJECTIVE
  To compare the level of pain reported by women by dose of mifepristone, 200 or 600mg, and describe the main factors related to the pain level in the 5 days after a medical abortion.
  
  
  METHODS
  Observational study in 11 medical centers in France between October 2013 and September 2014. The protocols were 200 or 600mg orally mifepristone on day 1 of the medical abortion and 400, 600 or 800μg orally misoprostol on day 3. Women returned a questionnaire that they completed during 5 days following the abortion; pain was recorded on a visual analog scale (0-10) daily.
  
  
  RESULTS
  453 women were included; the mean age was 29 years (range 18-49 years). Pain was greater with 200 than 600mg mifepristone: 33% of women reported a pain level of ≥8 on day 3 with 200mg as compared with 16% with 600mg. This difference remained after controlling for age, gestational age, gravidity, usual painful menstruation and misoprostol dose. Percentages of symptoms as vomiting or diarrhea were also lower with 600mg mifépristone than 200mg.
  
  
  CONCLUSIONS
  The mean pain severity experienced by women undergoing medical abortion is high; it is higher with a regimen of 200mg mifepristone. The findings emphasize the need to improve analgesic strategies and invite to opt for a protocol of 600mg instead of 200mg mifepristone.
authors.affiliation: INSERM UMR 1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, France. Electronic address: marie-josephe.saurel@inserm.fr.
authors.forename: Marie-Josèphe
authors.initials: MJ
authors.lastname: Saurel-Cubizolles
authors.affiliation: INSERM UMR 1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Opatowski
authors.affiliation: Maternité Clinique Jules Verne, 4 route de Paris, 44300 Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: David
authors.affiliation: Maternité Clinique Jules Verne, 4 route de Paris, 44300 Nantes, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Bardy
authors.affiliation: Fédération Nationale de la Mutualité Française, Fondation de l'Avenir, Paris, France.
authors.forename: Annabel
authors.initials: A
authors.lastname: Dunbavand
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D005602:France; D020073:Gravidity; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D000700:Analgesics; D016595:Misoprostol; D015735:Mifepristone
keywords: Medical abortion; Mifépristone; Pain