Medical abortion with mifepristone and misoprostol: a clinical trial in Taiwanese women.

BACKGROUND AND PURPOSE Medical abortion was not officially approved in Taiwan until the end of 2001. We investigated the efficacy of combination mifepristone and misoprostol therapy for medical abortion (which has now been approved) in early pregnant Taiwanese women and whether the attitudes of women who received this treatment affected the clinical outcome of medical abortion. METHODS Eighty healthy women in early pregnancy (< 49 d of gestation) were enrolled into two studies of medical abortion using mifepristone and misoprostol regimens. The outcomes were evaluated based on complete expulsion of intrauterine contents, with or without surgical intervention. Study 1 used treatment with mifepristone (200 mg or 600 mg) and misoprostol (400 micrograms), and the decision to perform surgical intervention was made mainly on the basis of the patient's request. Study 2 used treatment with mifepristone (200 mg or 600 mg) and misoprostol (600 micrograms) where the decision to perform surgical intervention was made exclusively by the physician. Serum or urinary human chorionic gonadotropin (hCG) concentration was measured serially after abortion. RESULTS In general, the success rate was 95% as judged by complete expulsion of intrauterine contents without surgical intervention. However, the success rate in Study 1 was only 62.5%. The mean duration of bleeding after abortion was 16.7 to 21.7 days. Serum or urinary hCG concentration remained positive in one woman (1.2%) studied during 43 to 60 days after abortion. CONCLUSION A combination of mifepristone and misoprostol for medical abortion in Taiwanese women during early pregnancy can achieve a high success rate. Our study showed that a mifepristone dose of 200 mg and a misoprostol dose of 400 micrograms were most effective. Our results suggest that sufficient physician and patient communication regarding medical abortion affects the clinical outcome.