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Home self-administration of misoprostol for medical abortion up to 56 days' gestation
  1. Haitham Hamoda, MRCOG, Clinical Research Fellow,
  2. Premila W Ashok, MD, MRCOG, Consultant and Honorary Senior Lecturer,
  3. Gillian M M Flett, FRCOG, Consultant in Family Planning and Reproductive Health and
  4. Allan Templeton, MD, FRCOG, Regius Professor in Obstetrics and Gynaecology and Head of Department
  1. Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen, UK
  1. Correspondence to Dr Haitham Hamoda, Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Cornhill Road, Aberdeen AB25 2ZD, UK. Telephone: +44 1224 553582. Fax: +44 1224 684880. E-mail: ogy262{at}abdn.ac.uk

Abstract

Objective Studies from the USA have suggested the feasibility and acceptability of home medical abortion, however the issue has not been addressed in the UK. This study aimed to assess the feasibility, efficacy and acceptability of home self-administration of misoprostol for medical abortion up to 56 days' gestation.

Methods Mifepristone 200 mg was given orally in hospital under nursing supervision. Women were provided with misoprostol tablets 600 μg and advised to take them sublingually 36–48 hours later. The main outcome measures were (1) feasibility, assessed through successful completion of abortion at home without the need for hospital admission, (2) efficacy, assessed through complete uterine evacuation without the need for further medical or surgical intervention and (3) women's acceptability of the procedure as assessed by questionnaire.

Results A total of 49 women participated in this study. Of these, 48 women aborted at home while one opted to be admitted to hospital after receiving misoprostol at home. One woman underwent surgical evacuation 5 weeks following abortion for excessive bleeding and retained products of conception. A total of 43/44 (98%) women were satisfied with having the abortion at home. Side effects experienced by women included nausea [32/40 (80%], vomiting [17/41 (42%)], diarrhoea [17/41 (42%)], shivering [26/40 (65%)], tiredness [32/40 (80%)], headache [12/39 (31%)], hot flushes [14/40 (35%)], dizziness [24/39 (62%)] and unpleasant mouth taste [19/38 (50%)].

Conclusions This study suggests the feasibility and acceptability of home self-administration of misoprostol for medical abortion up to 56 days' gestation. These findings need to be assessed in the context of a randomised trial.

  • Accepted February 1, 2005.

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  • Accepted February 1, 2005.

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