Pregnancy Termination: Chances of a medical termination failing? -checksum="53828" ends

Objectives:

To assess the outcome of a regimen of a reduced dose of mifepristone followed by one or two doses of vaginal misoprostol as a non-surgical method for termination of pregnancy.

Design:

Prospective observational study.

Setting:

Aberdeen Royal Infirmary, Aberdeen, Scotland.

Population:

Women seeking abortion under the 1967 Abortion Act.

Methods:

Factors influencing the outcome in a consecutive series of 4132 women undergoing early medical abortion in one Scottish teaching hospital since 1994.

Settings, Design and Main Outcome Measures:

Complete abortion rates following one or two doses of misoprostol. The effect of age, gestation, previous pregnancy and previous termination on complete abortion rates following the medical regimen.

Results:

Of the 4132 women, 95 (2.3%) aborted within 48 hours of mifepristone and a further 3942 (95.4%) achieved complete abortion following administration of one or two doses of misoprostol. Thus, the overall complete abortion rate was 97.7% (4037/4131). A total of 94 (2.3%) women required surgical intervention of whom 13 (0.3%) had a continuing pregnancy. Following change of the regimen to include the possibility of two doses of misoprostol the continuing pregnancy rates were significantly reduced (OR = 5.88) and gestation ceased to have an effect on overall efficacy. Women who had a previous abortion were more likely to have a failed medical abortion (OR = 2.09), while women with no previous termination, but a previous live birth were more likely to have a failed abortion (OR = 2.03).

Conclusion:

Mifepristone in combination with one to two doses of vaginal misoprostol is an effective regimen for early medical abortion. The option of administering two doses of misoprostol significantly reduced the ongoing pregnancy rates and abolished the effect of gestation on overall efficacy. Previous termination was the strongest predictor of failed medical abortion.

Please click on the required question.

• 1 What does the term abortion mean?
• 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
• 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped - e.g. Down Syndrome?
• 3A What is Tay Sachs and should we test for it?
• 4 How prevalent is pregnancy termination?
• 5 Why do unwanted pregnancies occur?
• 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
• 7 Should I terminate my pregnancy for social reasons?
• 8 How can my pregnancy be terminated?
• 9 What does a suction (surgical) termination of pregnancy involve?
• 10 What is a medical abortion?
• 11 What will happen to me if I have a medical abortion?
• 12 How do medical and surgical pregnancy termination compare?
• 13 What are the chances of medical termination failing?
• 14 What are the risks of pregnancy termination?
• 15 Why is there debate about the ethics of pregnancy termination?
• 16 Support Groups.
• 17 Where can I obtain more information?
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.