Choosing medical or surgical terminations of pregnancy in the first trimester: what is the difference?

Aust N Z J Obstet Gynaecol. 2009 Apr;49(2):211-5. doi: 10.1111/j.1479-828X.2009.00967.x.

Abstract

Background: Women seeking termination of pregnancy in Auckland, New Zealand can chose between medical and surgical options up to eight weeks gestation.

Aims: To assess demographic differences or changes over time between proportions of women choosing medical or surgical abortions at a single centre and determine whether changing the mifepristone-misoprostol interval from two to one day impacted on outcomes.

Methods: Retrospective audit of two consecutive years (December 2005-November 2006 and December 2006-November 2007) of first-trimester surgical and medical terminations where the mifepristone-misoprostol interval was reduced from two to one day between years. Analysis using descriptive statistics and assessment of probability of observed differences between groups.

Results: A total of 1495 terminations were performed in 2005-2006 and 1588 in 2006-2007. No significant difference (P = 0.4) of eligible women choosing medical (21% and 23%) or surgical abortion between years. Ethnicity, age and residency status did not influence choice. Medical termination of pregnancy was more likely in women who were without previous children (P = 0.009), pregnancies (P = 0.02) or terminations (P = 0.04). Medical termination was similarly effective within six hours with either two- or one-day intervals.

Conclusions: Both medical and surgical first-trimester abortions are safe and effective. It is optimal to be able to offer women choice. Reducing the medical interval to one day does not increase adverse outcomes.

MeSH terms

  • Abortifacient Agents / administration & dosage
  • Abortion, Induced / methods*
  • Abortion, Induced / psychology*
  • Adult
  • Choice Behavior*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Gravidity
  • Humans
  • Mifepristone / administration & dosage
  • Misoprostol / administration & dosage
  • New Zealand
  • Patient Participation*
  • Pregnancy
  • Pregnancy Trimester, First
  • Retrospective Studies
  • Vacuum Curettage
  • Young Adult

Substances

  • Abortifacient Agents
  • Misoprostol
  • Mifepristone