We compared post-abortion metrorrhagia in 185 women who used the mifepristone (600 mg) plus sulprostone (250 micrograms) drug combination and in 196 women who underwent vacuum aspiration. The patients were monitored for a 2 week period, with haemoglobin being measured on the day of the abortion and 2 weeks later. The women who had used the drug combination experienced a mean fall of 0.7 g/dl in haemoglobin (36% lost > 1 g/dl and 8% > 2 g/dl); haemoglobin concentrations remained stable in women who had had vacuum aspiration.
PIP: A comparative study of 381 French women undergoing first-trimester induced abortion by either RU-486 (600 mg) in combination with sulprostone (250 mcg) or vacuum aspiration found that the former method is associated with moderate but significant blood loss in the post-abortion period. Abortion seekers were given a choice of method; the 185 women in the drug-induced abortion group were significantly more likely than their surgical abortion counterparts to be employed in managerial positions and to have a university education. At the 14-day post-abortion follow-up, a mean fall in hemoglobin level of 0.71 g/dl from baseline was recorded among women in the RU-486 group; 36% lost more than 1 g/dl and 8% lost more than 2 g/dl. In the vacuum aspiration group, there was no change in hemoglobin concentrations. Multivariate analysis indicated that the variation in hemoglobin levels was significantly associated with abortion method (p 0.0001) but not with age, race, socioeconomic status, parity, or duration of pregnancy. Since women in developing countries tend to have low hemoglobin levels, especially small iron reserves, the issue of post-abortion metrorrhagia should be given careful consideration before the drug-induced abortion method is introduced.