One- and 2-day mifepristone–misoprostol intervals are both effective in medical termination of second-trimester pregnancy

Abstract

Termination of pregnancy because of fetal anomaly requires the utmost clinical sensitivity and individualized patient care. This study compared the efficacy of a 1-day mifepristone and misoprostol interval in medical termination of second-trimester pregnancy performed because of fetal anomaly with that of the standard 2-day interval among the first 100 women in each group. A 200 mg dose of mifepristone was used; 0.4 mg of misoprostol was administered vaginally at 3-h intervals until abortion occurred. When calculated from ingestion of mifepristone, the time to abortion was 28 h 25 min (28:25 h) [23:10–50:40 h; median (range)] and 52:43 h (45:55–83:15 h) ( P < 0.0001) in the 1- and 2-day mifepristone–misoprostol groups respectively. However, following initiation of misoprostol administration, the time to abortion [7:25 h (1:00–23:15 h)] was longer ( P < 0.05) in the 1-day interval group than in the 2-day interval group [6:20 h (0:45–36:30 h)]; by 12 h, 82 and 87% (n.s.) respectively of the subjects had aborted. The proportions of cases undergoing surgical evacuation of the uterus were 64 and 45% ( P < 0.001), in the 1- and 2-day interval groups respectively. Thus both 1- and 2-day mifepristone–misoprostol intervals are valuable in termination of second-trimester pregnancy.