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Outpatient Therapeutic Abortion With Mifepristone

From the First and Second Departments of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.

To study the usefulness of mifepristone for outpatient abortion induction, we administered 600 mg of mifepristone in a single dose to 50 women exhibiting delay of menses of between 4–15 days. All but two started to bleed within 1–3 days after mifepristone. This treatment resulted in complete abortion (uterine cavity empty by ultrasonography; hCG levels less than 30 IU/L) in 36 women. Pregnancy was terminated but the uterus retained placental fragments in eight women, and pregnancy continued normally in five women (10%). One woman with a fibromyoma required emergency curettage 2 days after mifepristone. Necrotic decidua was seen on histopathologic examination of the endometrial samples. In the whole series, we saw no changes in blood hemoglobin or hematocrit values, and all the women could continue their routine activities during the procedure. Thus, although a single dose of mifepristone is an effective abortifacient, it is not potent enough to be used in routine clinical practice for outpatient pregnancy termination.