SAFETY, EFFICACY, AND ACCEPTABILITY OF MEDICAL ABORTION IN CHINA, CUBA, AND INDIA - A COMPARATIVE TRIAL OF MIFEPRISTONE-MISOPROSTOL VERSUS SURGICAL ABORTION

OBJECTIVE: We investigated safety, efficacy, and acceptability of an o ral regimen of medical abortion compared with surgical abortion in thr ee developing countries. STUDY DESIGN: Women (n = 1373) with amenorrhe a less than or equal to 56 days chose either surgical abortion (as pro vided routinely) or 600 mg of mifepristone followed after 48 hours by 400 mu g of misoprostol. This is the appropriate design for studying s afety, efficacy, and acceptability among women selecting medical abort ion over available surgical services. RESULTS: The medical regimen had more side effects, particularly bleeding, than did surgical abortion but very few serious side effects. Failure rates for medical abortion, although low, exceeded those for surgical abortion: 8.6% versus 0.4% (China), 16.0% versus 4.0% (Cuba), and 5.2% versus 0% (India). Nearly half of failures among medical clients were not true drug failures, ho wever, but surgical interventions not medically necessary (acceptabili ty failures or misdiagnoses). Women were satisfied with either method, but more preferred medical abortion. CONCLUSION: Medical abortion can be safe, efficacious, and acceptable in developing countries.