OBJECTIVE: We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries. STUDY DESIGN: Women (n = 1373) with amenorrhea < or = 56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 micrograms of misoprostol. This is the appropriate design for studying safety, efficacy, and acceptability among women selecting medical abortion over available surgical services. RESULTS: The medical regimen had more side effects, particularly bleeding, than did surgical abortion but very few serious side effects. Failure rates for medical abortion, although low, exceeded those for surgical abortion: 8.6% versus 0.4% (China), 16.0% versus 4.0% (Cuba), and 5.2% versus 0% (India). Nearly half of failures among medical clients were not true drug failures, however, but surgical interventions not medically necessary (acceptability failures or misdiagnoses). Women were satisfied with either method, but more preferred medical abortion. CONCLUSION:Medical abortion can be safe, efficacious, and acceptable in developing countries.
RCT Entities:
OBJECTIVE: We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries. STUDY DESIGN:Women (n = 1373) with amenorrhea < or = 56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 micrograms of misoprostol. This is the appropriate design for studying safety, efficacy, and acceptability among women selecting medical abortion over available surgical services. RESULTS: The medical regimen had more side effects, particularly bleeding, than did surgical abortion but very few serious side effects. Failure rates for medical abortion, although low, exceeded those for surgical abortion: 8.6% versus 0.4% (China), 16.0% versus 4.0% (Cuba), and 5.2% versus 0% (India). Nearly half of failures among medical clients were not true drug failures, however, but surgical interventions not medically necessary (acceptability failures or misdiagnoses). Women were satisfied with either method, but more preferred medical abortion. CONCLUSION: Medical abortion can be safe, efficacious, and acceptable in developing countries.
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Keywords:
Empirical Approach; Genetics and Reproduction; Abortion, Drug Induced; Abortion, Induced; Americas; Asia; Biology; Caribbean; China; Comparative Studies; Cuba; Curettage; Developing Countries; Eastern Asia; Endocrine System; Family Planning; Fertility Control, Postconception; Hormone Antagonists; Hormones; India; Latin America; Misoprostol; North America; Obstetrical Surgery; Physiology; Prostaglandins; Prostaglandins, Synthetic; Research Methodology; Research Report; Ru-486; Southern Asia; Studies; Surgery; Treatment
Authors: Thoai D Ngo; Caroline Free; Hoan T Le; Phil Edwards; Kiet Ht Pham; Yen Bt Nguyen; Thang H Nguyen Journal: Int J Womens Health Date: 2014-10-30