COMPARATIVE EVALUATION OF THE CLINICAL COURSE OF MEDICAL ABORTION WITH 200 AND 600 MG OF MIFEPRISTONE: PROSPECTIVE COHORT STUDY
Subject and methods. The prospective cohort study included 1728 continuously selected early reproductive-aged outpatients who had sought medical advice for unwanted early pregnancy (up to 63 days of amenorrhea). The relative risk of exposure was estimated from odds ratio (OR) at 95% confidence interval. Results. The use of mifepristone 600 mg (Group 1) versus 200 mg caused 1.2-fold more frequent adverse reactions: bloody discharge (OR = 2.0), vomiting (OR = 1.5), nausea (OR = 1.4), low-grade fever (OR = 0.1), and dizziness (OR = 1.4). Expulsion of the ovum occurred in 99.34 and 99.88% of the patients in Groups 1 and 2, respectively (pχ 2 >0.05). In Group 1, the more common complications were noted to be progressive pregnancy (OR=5.4) and bleeding requiring medical care (OR = 1.6). The time of ovum expulsion and the duration of further bloody discharge did not depend on a medical abortion scheme. Conclusion. Reducing the mifepristone dose from 600 mg to 200 mg in combination with sublingual misoprostol 400 ßg fails to decrease the efficiency of medical abortion up to 63 days of amenorrhea and to increase the number of its complications. The history of surgical and missed abortions raises the frequency of complications of pharmacological abortion, such as progressive abortion and ovum remains, regardless of m ifepristone dosage.