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Reprod Health Matters. 2015 Feb;22(44 Suppl 1):75-82. doi: 10.1016/S0968-8080(15)43825-X.

Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City.

Author information

1
Coordinator of Reproductive Health, Secretariat of Health of Mexico City, Mexico City, Mexico.
2
Director, Gynuity Health Projects, New York, NY, USA.
3
Senior Program Associate, Gynuity Health Projects, New York, NY, USA. Electronic address: idzuba@gynuity.org.
4
Director of Legal Abortion Program, Hospital Materno Infantil Inguarán, Mexico City, Mexico.
5
Director of Reproductive Health Clinic, Centro de Salud Beatriz Velasco de Alemán, Mexico City, Mexico.
6
Independent consultant, Mexico City, Mexico.
7
Program Associate, Gynuity Health Projects, New York, NY, USA.
8
President, Gynuity Health Projects, New York, NY, USA.

Abstract

Extensive evidence exists regarding the efficacy and acceptability of medical abortion through 63 days since last menstrual period (LMP). In Mexico City's Secretariat of Health (SSDF) outpatient facilities, mifepristone-misoprostol medical abortion is the first-line approach for abortion care in this pregnancy range. Recent research demonstrates continued high rates of complete abortion through 70 days LMP. To expand access to legal abortion services in Mexico City (where abortion is legal through 12 weeks LMP), this study sought to assess the efficacy and acceptability of the standard outpatient approach through 70 days in two SSDF points of service. One thousand and one women seeking pregnancy termination were enrolled and given 200 mg mifepristone followed by 800 μg misoprostol 24-48 hours later. Women were asked to return to the clinic one week later for evaluation. The great majority of women (93.3%; 95% CI: 91.6-94.8) had complete abortions. Women with pregnancies ≤ 8 weeks LMP had significantly higher success rates than women in the 9th or 10th weeks (94.9% vs. 90.5%; p = 0.01). The difference in success rates between the 9th and 10th weeks was not significant (90.0% vs. 91.2%; p = 0.71). The majority of women found the side effects (82.9%) and the use of misoprostol (84.4%) to be very acceptable or acceptable. This study provides additional evidence supporting an extended outpatient medical abortion regimen through 10 weeks LMP.

KEYWORDS:

Mexico; medical abortion; mifepristone; misoprostol

PMID:
25702071
DOI:
10.1016/S0968-8080(15)43825-X
[Indexed for MEDLINE]
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