Abstract : Mifepristone-misoprostol abortion, consisting of oral pills, is potentially simple and safe enough for use in less-developed countries. But the labor-intensive, costly, clinic-based European protocols are not affordable or feasible in most less-developed countries. The authors prospectively tested two simplifications to the French mifepristone-misoprostol regimen in Vietnam and Tunisia. Women (n = 315) with amenorrhea of 8 weeks or less since their last menstrual period received 200 mg mifepristone in the clinic and then chose whether to take 400 mcg oral misoprostol 2 days later either at home or in the clinic. Despite a two-thirds reduction in the mifepristone dose, success rates were high: Vietnam 93%, Tunisia 91%. About 88% of participants chose home administration of misoprostol. Most Vietnamese and Tunisian women were satisfied with their abortions, but efficacy and satisfaction rates were higher among those who used misoprostol at home. A simplified medical abortion regimen of 200 mg mifepristone, followed by the option of home administration of misoprostol, seems feasible. (author's)
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