Safety, efficacy and acceptability of mifepristone-misoprostol medical abortion in Vietnam

International Family Planning Perspectives, Mar 1999 by Ngoc, Nguyen Thi Nhu, Winikoff, Beverly, Clark, Shelley, Ellertson, Charlotte, Et al

Resultats: Les taux de succes des deux methodes se sont averes extrlmement eleves (96% pour l'avortement medical et 99% pour la methode chirurgicale). Les patientes ayant choisi la procedure medicale ont signale beaucoup plus d'effets secondaires que celles qui avaient demande l'intervention chirurgicale (douleurs abdominales, saignements prolonges et nausees, surtout), mais aucun de ces effets ne presen tait de risque medical grave. Independamment de la methode choisie, presque toutes les femmes se sont declarees satisfaites de leur experience. De celles qui avaient subi un avortement chirurgical precedent, celles ayant choisi la procedure medicale se sont du reste revelees plus susceptibles, par rapport a leurs homologues qui avaient de nouveau choisi la methode chirurgicale, de qua/if er la procedure incluse dans l'etude de plus satisfaisante que la precedente (32% par rapport a 4%).

Conclusions: L'avortement provoque par mifepristone-misoprostol offre une methode sure, efficace et acceptable aux yeux des Vietnamiennes auxquelles un choix de methode est offert. Si des resultats comparables etaient observes dans les milieux ruraux, le regime pourrait aider a repondre au besoin de services d'avortement a l'echelle nationale.

*If a woman asked how long a medical abortion takes, she was informed that while the majority of women experience a complete abortion within several hours of taking the second set of pills, some wait up to two weeks to have a complete expulsion.

This ratio is not meaningful, because many women who preferred surgical abortion (particularly in Ho Chi Minh City) saw no reason to enroll in the study rather than simply to undergo the standard procedure.

*At the follow-up visit, three medical abortion patients had had incomplete abortions and were permitted to keep waiting for their abortions to become complete. Two of these women had complete abortions confirmed when they returned for an additional follow-up visit, a few days to one month after the first; the third woman received a surgical intervention, because her abortion still was not complete three days after her initial follow-up visit.

*Analysis of the mean number of days of bleeding, however, overestimates the total number of days of bleeding, since diary entries recording different types of bleeding on a single day were counted as separate days of bleeding. Thus, for example, if a woman recorded both normal and heavy bleeding one day, she was counted as having had a full day of each.

References

1. World Health Organization, Abortion: A Tabulation of Available Data on the Frequency and Mortality of Unsafe Abortion, second ed., Geneva: World Health Organization, 1994.

2. Bygdeman M et al., Progesterone receptor blockage: effect on uterine contractility and early pregnancy, Contraception,1985, 32(1):4r51.

3. Peyron R et al., Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol, New England Journal of Medicine, 1993, 328(21):1509-1513.