[Medical abortion--modern method for termination of pregnancy]

Modern methods of medically induced abortions are being used in many countries all over the world. These methods are safe and effective when used in an appropriate way.

The most widely used regimens for drug induced abortions include antiprogestogen mifepriston followed by administration of a synthetic prostaglandin analogue--gemeprost vaginally or misoprostol orally or vaginally. When used for abortions up to 9 and 7 weeks of pregnancy, this method has efficacy up to 98%. The regimen between 9 and 12 completed weeks is still under investigation. Methods for medical abortion after 12 completed weeks since last menstrual period include several regimens and medications--combination of mifepriston and repeated doses of misoprostol, misoprostol or gemeprost alone, methotrexate, synthetic prostaglandin analogues, oxytocin and some others.

Medical abortions in the second trimester were introduced at our Department of Obstetrics and Gynecology Novi Sad, Serbia, in early 1980s using prostaglandin analogues. This method was improved in year 2000 introducing two dinoprostone gels intracervically/extraaminally instead of just one, for cervical preparation before intramuscular application of carboprost thrometamine, which led to significantly shorter abortion interval. During the years 2003/2004 we took part successfully in one of the multicentric WHO projects for investigating new regimens on early medical abortions with mifepriston and misoprostol.

Modern methods of medical abortions are safe and effective for termination of unwanted pregnancies in the first and second trimester.