Termination of pregnancy. Methods, results, and complications

Abstract

ntroduction: Medical treatment for termination of pregnancy in the first trimester of pregnancy was first introduced in 2006 at Landspitali. This new method, which replaced surgery, slowly gained ground and now most abortions in Iceland are medically induced. It is therefore appropriate to evaluate the effectiveness and safety of this method. Two medications are administrated during medical termination of pregnancy, mifepristone (anti-gestagen) and misoprostol (prostaglandin). Material and methods: This is a retrospective cohort study including all terminations of pregnancies carried out at Landspitali from September 1st 2019 to December 31st 2022. Data on the method of induced abortion (medical or surgical), complications, and admissions within 60 days of treatment were obtained from the Department of Economics at Landspitali. A chi-square test was used for statistical processing. Results: The number of terminations of pregnancies at Landspitali during these 40 months was 2853. Of those, 2502 (87.7%) were medical abortions and 351 (12.3%) were surgical. Most were performed before 9 weeks of pregnancy or 85.3%. The medical group was significantly more likely to experience the complications of incomplete termination of pregnancy, with delayed or excessive bleeding, incomplete termination of pregnancy for other unspecified reasons, the need for evacuation of uterus due to incomplete abortion and hospital admission following treatment. A little more than 4% of those who received medical treatment for termination of pregnancy, underwent also surgical intervention for complications. Conclusion: The incidence of complications after medical termination of pregnancy is comparable to what has been observed in other Nordic countries. Despite a higher risk of incomplete abortion when drugs are used, the benefit of medical therapy over surgery is significant.