Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases

Haitham Hamoda, Premila Wencesiaus Ashok, G. M. Flett, Alexander Allan Templeton

    Research output: Contribution to journalArticle

    26 Citations (Scopus)

    Abstract

    OBJECTIVE: The purpose of this study was to assess the uptake and outcome of medical abortion in the late first trimester of pregnancy.
    STUDY DESIGN: We conducted a review of the cases of 483 consecutive women in a university hospital who underwent medical abortion at 64 to 91 days of gestation and who used mifepristone that was followed 36 to 48 hours later by repeated doses of misoprostol.
    RESULTS: A total of 891 abortions were carried out at 64 to 91 days of gestation from October 2000 to April 2002; of these, 483 cases (54.2%) were undertaken medically. Complete abortion occurred in 458 cases (94.8%). Efficacy decreased with advancing gestational age. Surgical evacuation was carried out in 1 woman (0.9%) at 9 to 10 weeks of gestation, in 8 women (5.3%) at 10 to 11 weeks of gestation, in 7 women (6.2%) at 11 to 12 weeks of gestation, and in 9 women (7.9%) at 12 to 13 weeks of gestation. Indications for surgery included ongoing pregnancy in 8 cases (1.7%), missed abortion in 3 cases (0.6%), incomplete abortion in 13 cases (2.7%), and emergency curettage for bleeding in 1 case (0.2%). The mean number of misoprostol doses used was 2.3; of those women who had a complete abortion, 152 women (32.6%) aborted within 4 hours of receiving the misoprostol. The mean induction to abortion interval was 5.5 hours; most cases (452; 93.6%) were treated as day cases.
    CONCLUSION: Medical abortion between 64 and 91 days of gestation is effective and has a high uptake. Consideration should be given to extending the availability and choice of medical abortion to women in this gestational group.

    Original languageEnglish
    Pages (from-to)1315-1319
    Number of pages4
    JournalAmerican Journal of Obstetrics and Gynecology
    Volume188
    Issue number5
    DOIs
    Publication statusPublished - May 2003

    Keywords

    • abortion
    • mifepristone
    • misoprostol
    • late first trimester
    • surgical vacuum aspiration
    • vaginal Misoprostol
    • trimester abortion
    • Mifepristone
    • termination
    • pregnancy
    • Gemeprost
    • induction
    • trial

    Cite this

    Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases. / Hamoda, Haitham; Ashok, Premila Wencesiaus; Flett, G. M.; Templeton, Alexander Allan.

    In: American Journal of Obstetrics and Gynecology, Vol. 188, No. 5, 05.2003, p. 1315-1319.

    Research output: Contribution to journalArticle

    Hamoda, Haitham ; Ashok, Premila Wencesiaus ; Flett, G. M. ; Templeton, Alexander Allan. / Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases. In: American Journal of Obstetrics and Gynecology. 2003 ; Vol. 188, No. 5. pp. 1315-1319.
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    abstract = "OBJECTIVE: The purpose of this study was to assess the uptake and outcome of medical abortion in the late first trimester of pregnancy. STUDY DESIGN: We conducted a review of the cases of 483 consecutive women in a university hospital who underwent medical abortion at 64 to 91 days of gestation and who used mifepristone that was followed 36 to 48 hours later by repeated doses of misoprostol. RESULTS: A total of 891 abortions were carried out at 64 to 91 days of gestation from October 2000 to April 2002; of these, 483 cases (54.2{\%}) were undertaken medically. Complete abortion occurred in 458 cases (94.8{\%}). Efficacy decreased with advancing gestational age. Surgical evacuation was carried out in 1 woman (0.9{\%}) at 9 to 10 weeks of gestation, in 8 women (5.3{\%}) at 10 to 11 weeks of gestation, in 7 women (6.2{\%}) at 11 to 12 weeks of gestation, and in 9 women (7.9{\%}) at 12 to 13 weeks of gestation. Indications for surgery included ongoing pregnancy in 8 cases (1.7{\%}), missed abortion in 3 cases (0.6{\%}), incomplete abortion in 13 cases (2.7{\%}), and emergency curettage for bleeding in 1 case (0.2{\%}). The mean number of misoprostol doses used was 2.3; of those women who had a complete abortion, 152 women (32.6{\%}) aborted within 4 hours of receiving the misoprostol. The mean induction to abortion interval was 5.5 hours; most cases (452; 93.6{\%}) were treated as day cases. CONCLUSION: Medical abortion between 64 and 91 days of gestation is effective and has a high uptake. Consideration should be given to extending the availability and choice of medical abortion to women in this gestational group.",
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    author = "Haitham Hamoda and Ashok, {Premila Wencesiaus} and Flett, {G. M.} and Templeton, {Alexander Allan}",
    year = "2003",
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    T1 - Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases

    AU - Hamoda, Haitham

    AU - Ashok, Premila Wencesiaus

    AU - Flett, G. M.

    AU - Templeton, Alexander Allan

    PY - 2003/5

    Y1 - 2003/5

    N2 - OBJECTIVE: The purpose of this study was to assess the uptake and outcome of medical abortion in the late first trimester of pregnancy. STUDY DESIGN: We conducted a review of the cases of 483 consecutive women in a university hospital who underwent medical abortion at 64 to 91 days of gestation and who used mifepristone that was followed 36 to 48 hours later by repeated doses of misoprostol. RESULTS: A total of 891 abortions were carried out at 64 to 91 days of gestation from October 2000 to April 2002; of these, 483 cases (54.2%) were undertaken medically. Complete abortion occurred in 458 cases (94.8%). Efficacy decreased with advancing gestational age. Surgical evacuation was carried out in 1 woman (0.9%) at 9 to 10 weeks of gestation, in 8 women (5.3%) at 10 to 11 weeks of gestation, in 7 women (6.2%) at 11 to 12 weeks of gestation, and in 9 women (7.9%) at 12 to 13 weeks of gestation. Indications for surgery included ongoing pregnancy in 8 cases (1.7%), missed abortion in 3 cases (0.6%), incomplete abortion in 13 cases (2.7%), and emergency curettage for bleeding in 1 case (0.2%). The mean number of misoprostol doses used was 2.3; of those women who had a complete abortion, 152 women (32.6%) aborted within 4 hours of receiving the misoprostol. The mean induction to abortion interval was 5.5 hours; most cases (452; 93.6%) were treated as day cases. CONCLUSION: Medical abortion between 64 and 91 days of gestation is effective and has a high uptake. Consideration should be given to extending the availability and choice of medical abortion to women in this gestational group.

    AB - OBJECTIVE: The purpose of this study was to assess the uptake and outcome of medical abortion in the late first trimester of pregnancy. STUDY DESIGN: We conducted a review of the cases of 483 consecutive women in a university hospital who underwent medical abortion at 64 to 91 days of gestation and who used mifepristone that was followed 36 to 48 hours later by repeated doses of misoprostol. RESULTS: A total of 891 abortions were carried out at 64 to 91 days of gestation from October 2000 to April 2002; of these, 483 cases (54.2%) were undertaken medically. Complete abortion occurred in 458 cases (94.8%). Efficacy decreased with advancing gestational age. Surgical evacuation was carried out in 1 woman (0.9%) at 9 to 10 weeks of gestation, in 8 women (5.3%) at 10 to 11 weeks of gestation, in 7 women (6.2%) at 11 to 12 weeks of gestation, and in 9 women (7.9%) at 12 to 13 weeks of gestation. Indications for surgery included ongoing pregnancy in 8 cases (1.7%), missed abortion in 3 cases (0.6%), incomplete abortion in 13 cases (2.7%), and emergency curettage for bleeding in 1 case (0.2%). The mean number of misoprostol doses used was 2.3; of those women who had a complete abortion, 152 women (32.6%) aborted within 4 hours of receiving the misoprostol. The mean induction to abortion interval was 5.5 hours; most cases (452; 93.6%) were treated as day cases. CONCLUSION: Medical abortion between 64 and 91 days of gestation is effective and has a high uptake. Consideration should be given to extending the availability and choice of medical abortion to women in this gestational group.

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    KW - mifepristone

    KW - misoprostol

    KW - late first trimester

    KW - surgical vacuum aspiration

    KW - vaginal Misoprostol

    KW - trimester abortion

    KW - Mifepristone

    KW - termination

    KW - pregnancy

    KW - Gemeprost

    KW - induction

    KW - trial

    U2 - 10.1067/mob.2003.267

    DO - 10.1067/mob.2003.267

    M3 - Article

    VL - 188

    SP - 1315

    EP - 1319

    JO - American Journal of Obstetrics and Gynecology

    JF - American Journal of Obstetrics and Gynecology

    SN - 0002-9378

    IS - 5

    ER -