[Mifepristone for induction of second trimester abortion].

BACKGROUND

We wanted to assess the effect of changing the regimen for termination from gemeprost to mifepristone and misoprostol.

METHOD

The study was prospective from 1994 to 2001 and included 179 women who had a second trimester termination of pregnancy because of fetal malformations. Three different regimens were used: The traditional regimen with vaginal application of gemeprost (77 patients), pretreatment with mifpristone followed by gemeprost (40 patients), and pretreatment with mifepristone followed by misoprostol (62 patients).

RESULTS

The induction-to-abortion interval was significantly shorter in the two groups receiving pretreatment with mifepristone than in the group treated solely with gemeprost, on average 9.7 and 9.5 hours compared to 22.7 hours (p < 0.001). All patients who received mifepristone aborted within 24 hours of start of induction, compared to 80 % of patients treated solely with gemeprost.

INTERPRETATION

The combination of mifepristone and misoprostol provides a non-invasive and effective regimen for second trimester termination of pregnancy. Pretreatment with mifepristone represents a major improvement. Misoprostol is cheaper than gemeprost, is stored in room temperature, and can be used orally as well as vaginally.