CHANGES IN THE CONCENTRATION OF ALPHA-FETOPROTEIN AND PLACENTAL HORMONES FOLLOWING 2 METHODS OF MEDICAL ABORTION IN EARLY-PREGNANCY

Objective Measurement of alpha-fetoprotein (AFP) was used to investiga te the occurrence of feto-maternal haemorrhage in women undergoing med ical abortion. Design Three groups of women with amenorrhoea of 56 or less days were studied. A control and a mifepristone group had two blo od samples taken 48 h apart. Women undergoing medical abortion with ge meprost had two blood samples taken 24 h apart. Setting Medical Termin ation Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Subjects T hree hundred and thirty-five women requesting abortion. Interventions Blood samples taken at 24 h or 48 h apart. Measurements and main resul ts The rise in concentration of AFP in plasma was much higher (P = 0.0 1) in the two groups of women in whom abortion was induced by gemepros t or mifepristone than in control women. Whereas only 5% of women in t he control group had a significant rise in AFP, 27% and 33% of women i n the mifepristone and gemeprost groups, respectively, had a rise in A FP level which exceeded the 95th centile (greater-than-or-equal-to 38% ). The concentration of hCG rose by 48 h in both control and mifeprist one groups. Progesterone remained unchanged, and oestradiol decreased (P<0.02) in the mifepristone group. By 24 h, there was a significant f all in the concentrations of hCG, progesterone and oestradiol in the g roup who had aborted after being given gemeprost. Conclusions Anti-D p rophylaxis must be administered to rhesus negative women to avoid rhes us iso-immunisation.