Medical and Surgical Abortion Are Equally Effective

Electronic medical records (EMRs) were reviewed for ongoing pregnancies after the initial abortion procedure. The researchers also collected data on complications occurring within the immediate period, such as unanticipated aspiration, perforation, hospitalization, transfusion, and infection.

The results showed that efficacy of pregnancy termination was 99.6% for medication abortions and 99.8% for surgical abortions. The medication abortion group, however, was more likely to undergo an unanticipated aspiration for ongoing pregnancy, persistent pain and bleeding, or both (2.1% compared with 0.6%). These rates were unchanged after controlling for gravidity, parity, and body mass index (BMI). There was no difference in major adverse events between the two groups. The study was published on June 5, 2015, in Obstetrics and Gynecology.

“Medication abortion and surgical abortion before 64 days of gestation are both highly effective with low complication rates,” concluded lead author Luu Doan Ireland, MD, MPH, and colleagues. “We wanted to explore whether different characteristics may impact the efficacy or safety of these abortion methods; patient age had an impact on both groups, increasing the risk by 3% with each year of patient age.”

Early first-trimester medical abortion regimens involve a 200 mg of oral mifepristone, followed 24–48 hours later by an 800 mcg dose of buccal misoprostol. This regimen, used by Planned Parenthood in the United States, is 98.3% effective through 59 days gestation. Mifepristone in combination with a prostaglandin analog (such as misoprostol) are also the most common methods used to induce second-trimester abortions in Canada, most of Europe, China, and India. In contrast, in the United States 96% of second-trimester abortions are performed surgically by dilation and evacuation.

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