A COMPARISON OF MEDICAL ABORTION (USING MIFEPRISTONE AND GEMEPROST) WITH SURGICAL VACUUM ASPIRATION - EFFICACY AND EARLY MEDICAL SEQUELAE

A total of 363 women undergoing legal abortion at < 63 days of amenorr hoea were allocated by a patient-centred, partially randomized study d esign to undergo medical abortion (using mifepristone 600 mg followed 48 h later by gemeprost 1 mg vaginal pessary) or vacuum aspiration (pe rformed under general anaesthesia). The aim of the study was to compar e the efficacy and complications of the two procedures. Main outcome m easures included efficacy rates, medical complications within 21 days of abortion and unplanned family doctor consultation rates within 8 we eks following abortion. Sequelae such as pain, vaginal bleeding and re covery time were assessed by the change in haemoglobin level, the time taken to return to work or normal activity and the analgesic use. Res ults were gestation-related; at <50 days of amenorrhoea there was litt le to choose between the two procedures. At 50 - 63 days of amenorrhoe a medical abortion becomes more painful and less effective, whereas va cuum aspiration retains high tolerance and efficacy. Women who are uns ure which method to use are likely to find vacuum aspiration more acce ptable at longer gestations.