Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curaçao

Abstract

Objective To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curaçao, where induced abortion is severely restricted by law.

Methods In a prospective study 330 women received 200 mg mifepristone and were instructed to take four tablets (800 μg) of misoprostol via the buccal route 24–36 h later, at home. One week later, follow-up took place.

Results The outcome could be evaluated in 307 of the 330 women. The efficacy of the mifepristone-buccal misoprostol procedure was 97.7% (300/307). In seven women vacuum aspirations for continuing pregnancy or incomplete abortion following treatment were required. Success rates at 64–70 days' gestation were the same as for gestations of less than 64 days duration. The main adverse effects were nausea and diarrhoea.

Conclusion Home administration of buccal misoprostol 24–36 h after mifepristone is a safe and effective method of medical abortion up to 70 days. It could be applied in a general practice in Curaçao, where induced abortion is legally restricted.

Keywords:

• Medical abortion
• Mifepristone
• Buccal misoprostol
• Home abortion
• Caribbean

Acknowledgements

Aimee Durand, general practitioner, contributed to this article.

Contribution to authorship

A. Boersma collected and analysed the cases and wrote the manuscript. G. Kleiverda and B. Meyboom-de Jong were involved in the interpretation of the data and the critical review of the manuscript. All authors approved the final version.

Funding

None.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and the writing of the paper.