INDUCTION OF 2ND TRIMESTER ABORTION WITH MIFEPRISTONE AND GEMEPROST

Objective To determine the efficacy of a new regimen of the antiproges togen mifepristone and gemeprost for midtrimester abortion. Design Pro spective study. Setting Medical Termination Unit, Simpson Memorial Mat ernity Pavilion, Edinburgh. Subjects One hundred women undergoing midt rimester abortion. Interventions Women were pretreated with 200 mg mif epristone 36 h before prostaglandin; 1 mg gemeprost was administered e very 6 h for the first 24 h. If abortion had not occurred, 1 mg gemepr ost was administered 3 hourly over the next 12 h. Measurement and main results Ninety-six percent and 99% women aborted within 24 h and 48 h , respectively. The median prostaglandin-abortion interval was signifi cantly shorter in multigravidae compared to primigravida (6.6 vs 8.2 h , P<0.01). The median number of gemeprost pessaries to induce abortion was only two and 47% of women required one pessary. The incidence of vomiting and diarrhoea was 31% and 5%, respectively. Eighty-four perce nt of women required intramuscular diamorphine for analgesia. Thirty-t hree percent of women required an evacuation of the uterus following a bortion. Conclusions The shortened induction-delivery interval followi ng pretreatment with mifepristone makes it. possible to conduct midtri mester abortion on a daycare basis.