The use of misoprostol for abortion at ≤ 9 weeks' gestation

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Abstract
Objective To verify the efficacy and safety of misoprostol for abortion at ≤ 63 days' gestation. Method A total of 175 women seeking elective abortion at < 63 days' gestation received 800 μg of misoprostol vaginally. This dose was repeated at 48 and 96 h if abortion did not occur. Afterwards, up to three additional 600-or 400-μg doses of misoprostol were administered if the uterus was not empty, as judged by ultrasound. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side-effects and vaginal bleeding. Results Complete abortion occurred in 161/175 (92.0%; 95% CI 87-96%) subjects and 14/175 (8.0%; 95% CI 4-13%) cases failed. The immediate success rate was 77.7% with the first dose, 13.7% with the second dose and 0.6% with the third dose. The decrease in hemoglobin was statistically significant (p = 0.009) but without clinical relevance; before treatment: 11.94 mg/dl (SD 1.60) and after treatment: 11.64 mg/dl (SD 1.08). No significant differences were obtained between success rates and failures in relation to age, gravidity, parity, previous abortions, race, gestational age and side-effects. The third main dose of misoprostol showed very little efficacy. Vaginal bleeding lasted 5.5 ± 2.8 days, spotting 5.7 ±3.1 days and total bleeding 11.2 ± 3.0 days. Conclusions The success percentage attained shows that 800 μg of misoprostol administered vaginally effectively causes abortion at ≤63 days' gestation.