Outpatient second trimester pregnancy termination

Abstract

We evaluated the efficacy of initiating a second trimester medical abortion outside of a health care facility using patient self-administered serial intravaginal misoprostol. Patients scheduled for second trimester medical termination of pregnancy were randomized to an inpatient or outpatient group. Both groups received a single 200-μg vaginal misoprostol tablet every 6 h. No other abortifacients were used. The home group self-administered the misoprostol and returned to the hospital for clinical reasons or after 24 h and again at 48 h. Forty-two women were assigned to the inpatient and 45 to the outpatient groups. There was no difference between the groups in demographics or indications for terminations. The median hours from first misoprostol to delivery of the fetus was 12 and 14 (inpatient versus outpatient, respectively; p = 0.28). The total median hours in hospital were 24 versus 11 (inpatient versus outpatient, respectively; p <0.05). Two patients (4%) in the outpatient group delivered the fetus outside of the hospital. There were no cases of hemorrhage in either group. Outpatient initiation of second trimester medical termination with self-administered misoprostol is effective and decreases time of hospitalization.