A comparative study of surgical and medical procedures: 932 pregnancy terminations up to 63 days gestation

The aim of this retrospective study was to compare the efficacy and complic ations associated with early medical and surgical pregnancy termination. Th e study population comprised 932 consecutive women undergoing pregnancy ter mination at gestations of 63 days or less. There were no age or parity diff erences between the study groups. Medical termination was performed with mi fepristone 200 mg orally and misoprostol 800 mug vaginally; surgical aspira tion termination was performed under general anaesthesia. Outcome measures were: surgical curettage for presumed retained products of conception; ongo ing pregnancy; and planned and emergency review in the unit. Early medical and surgical termination were associated with a 90.2 and 94.5% complete abo rtion rate respectively (P = 0.025). The complete abortion rate with medica l termination decreased significantly with increasing parity; no such relat ionship with surgical abortion was found. Women of parity three or more wer e less likely to have a complete abortion following a medical (83.3%) compa red to surgical procedure (97.7%) (P = 0.028), The ongoing pregnancy rate w as 0.9% with medical and 0.5% with surgical termination (P NS). Medical ter mination was associated with a lower complete abortion rate than surgical t ermination, particularly for women of higher parity. However, early medical termination allows over 90% of women to avoid the risks of surgical instru mentation of the uterus and anaesthesia.