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Comparison of misoprostol-only and combined mifepristone–misoprostol regimens for home-based early medical abortion in Tunisia and Vietnam
International Journal of Gynecology & Obstetrics, 06/12/2012
Clinical Article
Blum J et al. – Mifepristone plus misoprostol is significantly more effective than misoprostol–only for early medical abortion.
Methods- A double–blind randomized placebo controlled study was conducted that enrolled 441 pregnant women (<63days since last menstrual period) at 2 hospitals in Tunisia and Vietnam.
- The mifepristone–misoprostol group (n=220) received 200mg of mifepristone on day 1 and 800μg buccal misoprostol followed by placebo 3hours later on day 2.
- The misoprostol–only group (n=221) received placebo on day 1 and 1600μg of misoprostol (2 doses of 800μg, given 3hours apart) on day 2.
- All medications were self–administered at home with follow–up 1week later. The primary outcome was complete uterine evacuation without surgical intervention.
- Successful uterine evacuation occurred for 78.0% (n=170) of women with misoprostol only versus 92.9% (n=195) of women with mifepristone–misoprostol (relative risk 0.84, 95% CI, 0.78–0.91; P<0.001).
- Ongoing pregnancy occurred for 13.8% (n=30) of women given misoprostol–only and 1.4% (n=3) of women given mifepristone–misoprostol (relative risk 9.63, 95% CI 2.98–31.09; P<0.001).
