A comparative study on the effectiveness, safety and acceptability of medical abortion at home between gestational age up to 49 days and from 50 to 63 days

Background: Medical abortion is the method to terminate the pregnancy by using mifepristone and misoprostol tablets by giving them at 48 hours interval. As per WHO medical abortion is a safe and effective method upto 9 weeks (63 days) of gestation.In home setting mifepristone isusually given in clinic and misoprostol self-administered by woman at home.We hypothesized that both mifepristone and misoprostol can be given in home based setting.
Objectives: To compare the effectiveness and safety of mifepristone and misoprostol upto 49 days of gestation with gestational age of 50-63 days in complete home based setting.
Method: nThis prospective, comparative study was done on 210 women who opted for first trimester abortion upto 63 days of gestation. They were divided into two groups: Group 1 with gestational age of ≤ 49 days and Group 2 with gestational age of 50-63 days. After confirmation of gestational age by transvaginal ultrasonography oral mifepristone (200mg) was followed after 48 hours by sublingual misoprstol (800μg), both self-administered by the women at home. They returned for follow-up after 14 days to confirm the completeness of abortion. Primary aim was to evaluate the efficacy of medical regimen in the form of percentage of complete abortion. And secondary aim was to compare the safety profile and acceptability in both the groups.
Result: In this study, conducted in complete home based setting, it was found that overall in both the groups the success rate in the form of complete abortion was high (95.7%) and both the groups were comparable with 97% complete abortion in group 1 and 93.8% in group 2, p value being 0.4522.Side effects profiles in both the groups were also low and comparable.
Conclusion: Our study shows the efficacy and safety of mifepristone and misoprostol upto 63 days of gestation in home setting for medical abortion. It also shows a high acceptability rate amongst women. Women should be offered this option to allow more flexibility and privacy in their abortions.