BLOOD-LOSS WITH MIFEPRISTONE-MISOPROSTOL ABORTION - MEASURES FROM A TRIAL IN CHINA, CUBA AND INDIA

Objective: We compared bleeding patterns following early mifepristone- misoprostol abortion with those following early surgical abortions (le ss than or equal to 56 days gestation LMP). We analyzed women's report s of their bleeding and clinical measures of blood loss, and modeled t he relationships between different bleeding measures and indicators of success and satisfaction. Method: Using data from a multicenter trial held in China, Cuba and India, we fit bivariate and multivariate mode ls to analyze bleeding patterns, controlling for a range of demographi c, experiential and medical factors (n = 1373). Result: Medical aborti on patients perceived their bleeding to be heavier than did the surgic al patients; however, there were few statistically significant differe nces in clinical measures of blood loss between the two groups, and bl ood loss rarely represented a medical problem. Nationality, far more t han actual levels of bleeding, influenced women's impressions about bl ood loss. Although medical abortion patients saw their bleeding as hea vier than did the surgical patients, their perceptions of heavier blee ding did not prevent them from having higher satisfaction levels. One exception was that if bleeding exceeded prior expectations, women with the medical method were more likely to be dissatisfied. Pain and cram ps, which often accompanied bleeding, were an independently significan t factor in predicting satisfaction with the method. Conclusion: In or der for women to know what to expect with medical abortion, they must be informed beforehand about the level of bleeding that generally acco mpanies the procedure vs. excessive bleeding that would signal a clini cal problem. (C) 1998 International Federation of Gynecology and Obste trics.