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First trimester termination of pregnancy
1Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 6/F, Professorial Block, 102 Pokfulam Road, Hong Kong.
Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 18, 2019
Summary
First trimester termination of pregnancy (TOP) is safe and effective. Surgical abortion via vacuum aspiration (VA) has a 97% success rate, while medical abortion using mifepristone and misoprostol achieves 95% success.
Area of Science:
- Reproductive Health
- Gynecology
Background:
- First trimester termination of pregnancy (TOP) is a common procedure.
- Both surgical and medical methods are available for TOP.
Purpose of the Study:
- To review the efficacy and safety of surgical and medical abortion methods for first-trimester TOP.
- To outline recommended protocols and potential complications.
Main Methods:
- Review of existing literature on surgical (Vacuum Aspiration - VA) and medical abortion.
- Analysis of success rates, complication risks, and management strategies.
Main Results:
- Surgical abortion (VA) has a complete abortion rate of approximately 97% with low rates of significant bleeding (≤5%) and major complications (<1%).
- Medical abortion using mifepristone and misoprostol has a 95% complete abortion rate, with potential need for repeated doses, especially after 9 weeks gestation.
- Prophylactic antibiotics, pre-operative misoprostol, and screen-and-treat strategies can reduce infection risk after VA. Gastrointestinal upset is common with medical abortion, but major complications are rare.
Conclusions:
- First-trimester TOP via VA or medical management is safe and effective.
- Specific protocols and precautions can optimize outcomes and minimize risks for both methods.
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