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The following is a summary of “Comparison of medication abortion outcomes at less than and greater than 6 weeks gestation,” published in the August 2024 issue of Obstetrics and Gynecology by Dethier et al.
Researchers conducted a retrospective study to compare outcomes and characteristics of patients receiving medication abortion (MAB) at ≤42 days gestation and those at 43-56 days gestation.
They compared 142 patients receiving MAB at ≤42 days with 200 patients receiving it at 43-56 days(2022). A 7% difference in MAB success was aimed for, with a power of 80% and an alpha level of 0.05. Follow-up responses and unscheduled healthcare contacts were assessed.
The results showed similar abortion success rates for the ≤42 days and 43-56 days groups (94.3% vs. 97%, P=0.226). The ≤42 days group had more unscheduled office visits (13% vs. 6%, P=0.01) but no difference in phone calls or emergency room visits. More patients with successful MAB in the ≤42 days group reported that bleeding (11.7% vs. 1.9%, P=0.006) and cramping (10.5% vs. 2.9%, P=0.035) were comparable to or lighter than a period and that had no pregnancy symptoms before the abortion (15.8% vs. 6.0%, P=0.034). Patients at ≤42 days gestation had fewer pre-treatment ultrasounds (48% vs. 64%, P=0.004), and those without prior ultrasounds required uterine aspiration more frequently to complete the abortion (6.8% vs. 2%, P=0.027).
Investigators concluded that patients undergoing MAB at ≤42 days have similar success rates but experience more unscheduled office visits and ambiguous symptoms when using standardized questions, suggesting the need for adapted anticipatory guidance and counseling.
Source: contraceptionjournal.org/article/S0010-7824(24)00391-3/abstract
