Medical Abortion at Gestational Age ≤ 24 weeks at Songklanagarind Hospital
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Abstract
Objectives: To determine the success and complication rates of medical abortion at gestational age ≤ 24 weeks, and to identify their associated factors.
Materials and Methods: A retrospective study was conducted from January 2006 to December 2017. Medical records of pregnant women at gestational age ≤ 24 weeks, who were admitted for medical abortion, were reviewed. Spontaneous abortion was excluded. Multivariate logistic regression analysis was used to identify factors associated with success and complications. A p value of < 0.05 was considered statistically significant.
Results: A total of 717 cases were reviewed. Two medical regimens were used, including misoprostol alone (84.7%) and mifepristone-misoprostol (MM) (15.3%). The overall success rates in the first and second trimester were 65.8% and 79.3%. The highest success rate was observed in women at gestational age of ≤ 9 weeks, with the MM regimen (92.0%). The overall complication rate was 5.3%, including hemorrhage requiring blood transfusion (4.7%) and infection (0.6%). The complication rates in the first and second trimester were 2.5% and 5.6%, respectively. One factor associated with success in the first trimester was the drug regimen (MM); while that in the second trimester was maternal age. Multivariate analysis showed that factors associated with complications in the second trimester were multigravida and having an underlying disease.
Conclusion: Medical abortion at gestational age ≤ 24 weeks had low complications. Multigravida and having an underlying disease were factors associated with complications in the second trimester.
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