Abstract
Objective
To compare duration of medication abortion after pretreatment with mifepristone versus misoprostol-only regimens at 22 + 0/7 to 30 + 0/7 weeks gestational duration.
Methods
This retrospective cohort study included patients admitted for medication abortion from 2014 to 2022. Included patients underwent feticide due to genetic or anatomical abnormalities at gestational duration of 22 + 0/7 to 30 + 0/7 weeks. Excluded from the study were patients admitted at gestational duration of < 22 + 0/7 or > 30 + 0/7 weeks, multiple gestation, diagnosis of intrauterine fetal demise before feticide, with contraindication for vaginal delivery and who were administered a medical regimen other than the mifepristone-misoprostol or misoprostol-only protocol. Information collected included patients’ demographics, clinical outcome, additional procedural interventions, and complications. Data of patients treated with mifepristone-misoprostol versus misoprostol-only were compared.
Results
The study group included 46 patients in the mifepristone-misoprostol group and 35 in the misoprostol-only group. Median interval from first dose of misoprostol to fetal expulsion was shorter in the mifepristone-misoprostol group (10.6 vs. 15.3 h; p = 0.007) with shorter duration of hospitalization (3.5 ± 1.1 vs. 4.1 ± 1.2 days; p = 0.013). Study groups were no different in terms of complications. Patients in the mifepristone group had an earlier gestational duration (23.8 ± 1.69 vs. 25.37 ± 2.4 weeks; p = 0.002). However, multivariable Cox regression found that mifepristone-misoprostol was independently associated with shorter induction (OR 1.7, 95% CI 1.03–2.9, p = 0.03,).
Conclusion
medication abortion with mifepristone-misoprostol was associated with shorter time to fetal expulsion at 22 + 0/7 to 30 + 0/7 weeks gestational duration, compared with misoprostol-only regimen.