The learning curve is rapid in medical termination of pregnancy--first-year results from the Helsinki area.

Medical termination of pregnancy by means of mifepristone and prostaglandin became available in Finland in May 2000. We summarize the first year results of medical abortion in a large tertiary care unit in Helsinki. A regimen of 200 mg of mifepristone followed by 0.4 mg vaginally administered misoprostol 2 days later was used. The maximum duration of pregnancy was 56 days. Four hundred and seventeen women, 47% of those with a pregnancy duration of up to 56 days, chose medical instead of surgical abortion. The monthly percentage of medical abortions varied from 27% to 63%. The percentage of complete terminations increased from 92% among the first quarter of the subjects to 97% among the fourth quarter, the overall success rate being 95%. Subject satisfaction, duration and self-estimated amount of bleeding, as well as analgesia needs were similar to those reported elsewhere. Most subjects (61%) chose combined oral contraceptive (COC) pills for future contraception; 75% of the COCs were started around the day of misoprostol administration. The reported amounts and duration of bleeding were not influenced by the immediate start of oral contraceptives. Intrauterine contraception was planned for 28% of the subjects, and 16% of them chose a levonorgestrel-releasing intrauterine device. We conclude that the learning curve in medical termination of pregnancy is rapid, and results comparable to those in centers with extensive experience with the method can be reached within the first year.