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Obstetrics & Gynecology:
doi: http://10.1097/AOG.0b013e3182755763
Original Research

Significant Adverse Events and Outcomes After Medical Abortion

Cleland, Kelly MPA, MPH; Creinin, Mitchell D. MD; Nucatola, Deborah MD; Nshom, Montsine MPH; Trussell, James PhD

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Abstract

OBJECTIVE: To analyze rates of significant adverse events and outcomes in women having a medical abortion at Planned Parenthood health centers in 2009 and 2010 and to identify changes in the rates of adverse events and outcomes between the 2 years.

METHODS: In this database review we analyzed data from Planned Parenthood affiliates that provided medical abortion in 2009 and 2010 almost exclusively using an evidence-based buccal misoprostol regimen. We evaluated the incidence of six clinically significant adverse events (hospital admission, blood transfusion, emergency department treatment, intravenous antibiotics administration, infection, and death) and two significant outcomes (ongoing pregnancy and ectopic pregnancy diagnosed after medical abortion treatment was initiated). We calculated an overall rate as well as rates for each event and identified changes between the 2 years.

RESULTS: Among 233,805 medical abortions provided in 2009 and 2010, significant adverse events or outcomes were reported in 1,530 cases (0.65%). There was no statistically significant difference in overall rates between years. The most common significant outcome was ongoing intrauterine pregnancy (0.50%); significant adverse events occurred in 0.16% of cases. One patient death occurred as a result of an undiagnosed ectopic pregnancy. Only rates for emergency department treatment and blood transfusion differed by year and were slightly higher in 2010.

CONCLUSION: Review of this large data set reinforces the safety of the evidence-based medical abortion regimen.

LEVEL OF EVIDENCE: III

© 2013 The American College of Obstetricians and Gynecologists

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