One or two day mifepristone-misoprostol interval for second trimester abortion

Area of Science:

• Reproductive Health
• Medical Interventions
• Obstetrics and Gynecology

Background:

• Second-trimester induced abortions are often performed using medication regimens.
• The timing of medication administration can influence procedure effectiveness and patient experience.
• Optimizing the interval between mifepristone and misoprostol is crucial for improving care.

Purpose of the Study:

• To compare the efficacy and outcomes of a 1-day versus a 2-day interval between oral mifepristone and vaginal misoprostol for second-trimester induced abortion.
• To evaluate the impact of the drug interval on time to fetal expulsion and overall abortion success.
• To assess factors influencing the time to abortion, such as gestational age and parity.

Main Methods:

• A retrospective cohort study involving 127 women undergoing induced abortion between 13 and 24 weeks of gestation.
• Participants received oral mifepristone (200 mg) followed by vaginal misoprostol (400 microg) every 3 hours.
• The study compared outcomes based on a 1-day versus a 2-day interval between the two medications.

Main Results:

• The 1-day interval group experienced a longer time to fetal expulsion (9.8 vs. 7.5 hours; p<0.01) compared to the 2-day interval group.
• Abortion success rates were high (98%) within 24 hours in both groups, with identical median numbers of misoprostol applications.
• Longer abortion times were observed in women with higher gestational age (17-22 weeks) and in nulliparous women.

Conclusions:

• The combined mifepristone-misoprostol regimen is effective for second-trimester induced abortion.
• The interval between mifepristone and misoprostol can be shortened, enabling personalized patient management.
• This optimized regimen supports efficient and effective second-trimester abortion care.