M. Olver
Speeches:
-
What is the outcome of pregnancies that continue
following administration of mifepristone?
Olver, M; Scherf, C; Noble, N
Cardiff and Vale NHS Health Board, UK
Introduction: The number of medical terminations of pregnancy
(TOPs) in England and Wales in 2010 compared with the year
2000 shows an 8% increase. Despite the rapid increase there is
little published evidence regarding the risks to a continuing
pregnancy after mifepristone administration.
Objectives: To investigate the outcome of all cases of continuing
pregnancy after administration of mifepristone +/- misoprostol in
the Cardiff and Vale University Health Board over a period of
4 years.
Methods: A retrospective case note review of all women with
unplanned pregnancies who wished to continue their pregnancy
after administration of mifepristone. Women were identified by
non-attendance or cancellation for misoprostol, follow-up cases
and searching antenatal records. The review period was 2007–2011.
Results: Twenty cases of continuing pregnancies were identified.
Of these, 10 resulted in live birth, five in miscarriage, two were
lost to follow-up and three needed a second TOP procedure (one
of them was given Clause E, fetal abnormality).
Conclusion: This case series shows the most common
complication following mifepristone administration is miscarriage
in the first trimester. Those pregnancies leading to live birth did
not result in adverse fetal outcomes. However, due to the small
sample size, damage to the fetus cannot be ruled out and
therefore close monitoring throughout pregnancy should be
performed. This detailed case review highlighted the need for
more work in this area to enable clinicians to provide correct
advice to women in these difficult situations.