M. Olver


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    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.