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Eur J Contracept Reprod Health Care. 2017 Feb;22(1):76-80. doi: 10.1080/13625187.2016.1258461. Epub 2016 Nov 21.

Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia.

Author information

1
a Gynuity Health Projects , New York , NY , USA.
2
b Gynuity Health Projects , Tbilisi , Georgia.
3
c Department of Obstetrics and Gynaecology No2 , Yerevan State Medical University , Yerevan , Armenia.
4
d Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynaecology , Yerevan , Armenia.

Abstract

OBJECTIVES:

The aim of the study was to assess the efficacy and acceptability of a regimen using mifepristone and buccal misoprostol with unlimited dosing for second trimester abortion in Armenia.

METHODS:

Women seeking to terminate 13-22 week pregnancies were enrolled in the study. Participants swallowed 200 mg mifepristone in the clinic and were instructed to return to the hospital for induction 24-48 h later. During induction, women were given 400 μg buccal misoprostol every 3 h until the fetus and placenta were expelled. The abortion was considered a success if complete uterine evacuation was achieved without oxytocin or surgery.

RESULTS:

A total of 120 women with a median gestational age of 18 weeks participated in the study. All women began misoprostol induction around 24 h after taking mifepristone. Complete uterine evacuation was achieved in 119 (99.2%) women. The median induction-to-abortion interval was 10.3 h (range 4-17.4) with a mean of 9.5 ± 2.5 h. A median of four misoprostol doses (range 2-6) with a mean of 4 ± 1 misoprostol doses were administered. The induction-to-abortion interval, number of misoprostol doses, pain score and analgesia use increased as gestational age advanced. Acceptability of the method was high among both patients and providers.

CONCLUSION:

The medical abortion regimen of 200 mg mifepristone followed 24 h later by induction with 400 μg buccal misoprostol administered every 3 h, with no limit on the number of doses used for the termination of pregnancies of 13-22 weeks' gestation is an effective and acceptable option for women.

KEYWORDS:

Armenia; medical abortion; mifepristone; misoprostol; second trimester

PMID:
27871191
DOI:
10.1080/13625187.2016.1258461
[Indexed for MEDLINE]

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