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Human Reproduction, Vol. 16, No. 1, 67-71, January 2001
© 2001 European Society of Human Reproduction and Embryology

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

T.J. Child1, J. Thomas, M. Rees and I.Z. MacKenzie

Department of Obstetrics and Gynaecology, Women's Centre, The John Radcliffe Hospital, Headington, Oxford, UK

The aim of this retrospective study was to compare the efficacy and complications associated with early medical and surgical pregnancy termination. The study population comprised 932 consecutive women undergoing pregnancy termination at gestations of 63 days or less. There were no age or parity differences between the study groups. Medical termination was performed with mifepristone 200 mg orally and misoprostol 800 µg vaginally; surgical aspiration termination was performed under general anaesthesia. Outcome measures were: surgical curettage for presumed retained products of conception; ongoing pregnancy; and planned and emergency review in the unit. Early medical and surgical termination were associated with a 90.2 and 94.5% complete abortion rate respectively (P = 0.025). The complete abortion rate with medical termination decreased significantly with increasing parity; no such relationship with surgical abortion was found. Women of parity three or more were less likely to have a complete abortion following a medical (83.3%) compared to surgical procedure (97.7%) (P = 0.028). The ongoing pregnancy rate was 0.9% with medical and 0.5% with surgical termination (P = NS). Medical termination was associated with a lower complete abortion rate than surgical termination, particularly for women of higher parity. However, early medical termination allows over 90% of women to avoid the risks of surgical instrumentation of the uterus and anaesthesia.

Key words: abortion/medical/mifepristone/surgical/termination

1 To whom correspondence should be addressed at: McGill Reproductive Centre F6, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3A 1A1, Canada. E-mail: Tim.child{at}muhc.mcgill.ca


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