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Related Experiment Videos

Outpatient second trimester pregnancy termination.

J A Gonzalez1, S J Carlan, M W Alverson

  • 1Department of Obstetrics and Gynecology, Arnold Palmer Hospital for Children and Women, Orlando, FL, USA.

Contraception
|April 9, 2001
PubMed
Summary

Initiating second trimester medical abortion at home with self-administered misoprostol is effective. This outpatient approach significantly reduces hospitalization time without compromising safety.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Pharmacology

Background:

  • Second trimester medical abortion is a common procedure.
  • Current protocols often require prolonged hospitalization.
  • Exploring outpatient management can improve patient experience and resource utilization.

Purpose of the Study:

  • To evaluate the efficacy and safety of initiating second trimester medical abortion outside a healthcare facility.
  • To compare inpatient versus outpatient management using self-administered misoprostol.
  • To assess the impact on hospitalization duration and patient outcomes.

Main Methods:

  • Randomized controlled trial comparing inpatient and outpatient groups for second trimester medical abortion.
  • Both groups received serial intravaginal misoprostol (200 mcg every 6 hours).

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  • Outpatient group self-administered medication at home, returning for assessment at 24 and 48 hours or if clinically indicated.

    • Main Results:

    • No significant difference in the median time from first misoprostol dose to fetal delivery (12 vs. 14 hours).
    • Outpatient management significantly reduced total median hospital stay (11 vs. 24 hours; p < 0.05).
    • Two outpatient patients (4%) delivered outside the hospital; no hemorrhages occurred in either group.

    Conclusions:

    • Outpatient initiation of second trimester medical abortion with self-administered misoprostol is effective.
    • This approach is safe and significantly decreases the duration of hospitalization.
    • Home-based management offers a viable alternative for selected patients undergoing medical abortion.