Medical abortion in women of <=56 days amenorrhoea; a comparison between gemeprost (a PGE1 analogue) alone and mifepristone and gemeprost

Objective To determine the efficacy of a new dose regimen of vaginal gemeprost (l mg every 6 h up to three doses) in induction of abortion in women ≤56 days gestation, and to compare this regimen with mifepristone (200–600 mg) followed 48 h later by a single dose of gemeprost (l mg). Design Two separate protocols, with 50% of the subjects randomized to one or other protocol. Setting The Royal Infirmary of Edinburgh, Scotland, UK Subjects 301 referred by their general practitioner or local family planning clinic, requesting termination of pregnancy at ≤56 days amenorrhoea. Interventions Ongoing pregnancies and incomplete abortions were terminated surgically. Main outcome measures Number of complete abortions, analgesic requirements and bleeding pattern following treatment. Results Complete abortion occurred in 87% of women treated with gemeprost alone and 98% of women treated with mifepristone and gemeprost (P=0.0004). Analgesic requirements were greater in the group treated with gemeprost alone, compared with the group treated with mifepristone and gemeprost (P=0.0001). Conclusion The new dose regimen of gemeprost can be used for early induced abortion, but the use of mifepristone and gemeprost has several advantages over the use of gemeprost alone.