Termination of early pregnancy with a reduced oral dose of mifepristone and vaginal misoprostol

To determine the efficacy of termination of pregnancy with a reduced oral dose of mifepristone and vaginal misoprostol. A retrospective review of 369 medical terminations of pregnancy. Northern General Hospital, Sheffield, UK. All women presenting for medical termination of pregnancy before 63 days' gestation between October 1996 and December 1997. Patients were pre-treated with mifepristone 200 mg orally, 36-48 hours before the prostaglandin E analogue, misoprostol, was administered vaginally. Two doses of misoprostol 400 micrograms, were given 2 hours apart. Women were allowed home 6 hours after the first dose of misoprostol. If the products of conception were not passed before going home, patients were to contact the hospital if bleeding did not take place within 4 days. Need for a surgical procedure and number of ongoing pregnancies after full treatment were considered primary outcome measures. A total of 369 women were treated with this regimen: 343 women (93.46%) aborted completely within a 6-hour observation period and did not require further intervention. A further 8 women aborted completely within the next 4 days. Overall, the complete abortion rate was 95.64%. Surgical intervention was necessary in 1.09% of the patients. No woman had serious complications. This combination is effective, safe and cost-effective in a clinical setting.