BLOOD-LOSS IN TERMINATION OF EARLY-PREGNANCY WITH MIFEPRISTONE AND GEMEPROST

The combination of an antiprogestogen with prostaglandin has been show n to be an effective alternative to surgical procedures for pregnancy termination in the first 49 days of amenorrhoea and has been available in France since late 1988. Mifepristone when used alone caused poor e fficacy with unacceptable vaginal bleeding. The addition of a prostagl andin analogue (sulprostone, gemeprost) produced acceptable efficacy w ith less bleeding. The present study provides a quantitative assessmen t of blood loss in a sample of 20 women undergoing medical termination of early pregnancy (amenorrhoea less than or equal to 49 days). Vagin al bleeding occurred between days 3 and 15 of commencing therapy. The median number of days of bleeding was 4 with a median blood loss of 91 .5 mL. The mean blood loss was 136.8 mL (+/- SD 159.2) but this did no t adversely affect the hemoglobin level in the volunteers. Most patien ts describe the experience as that similar to a heavy period and viewe d the procedure positively especially since they are spared the anaest hetic risks and hospitalization attendant with surgical abortion. Caut ion is still however advised as there may be the occasional subject wi th excessive haemorrhage (as in this study where one woman bled a tota l of 761.4 mL) and close supervision by a physician is essential.