I. Nisand


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    Medical management of unwanted pregnancy in
    France: modalities and outcomes. The aMaYa study
    Nisand, I; Bettahar, K
    Gynaecolgy Department CHU Strasbourg, France
    Background/Methods: Since WHO recommendations in 2003, the
    use of medical termination of pregnancy (MToP) has become
    wider in Europe, particularly in France where it concerns more
    than 50% of TOPs. However, there are still different practices
    according to various guidelines or drug approvals. Following the
    recent update of French recommendations (December 2010), a
    new observational study was performed to assess in real life
    modalities and outcomes in mToP.
    Results: One thousand five hundred and eighty-seven women
    (mean age: 27.6 ± 6.8; minor: 3.3%) were included by 48 French
    specialised centres from September 2011 to April 2012. At the
    inclusion, when women were given mifepristone, the gestation of
    pregnancy was £49 days of amenorrhoea (DA) for 71.7% of
    patients and >49 DA for 28.3% with >63 DA for 2.1%. Most of
    the time pregnancy dating was done by ultrasound. The most
    frequently used protocol was the one recommended by the French
    authorities (mifepristone 600 mg-misoprostol 400 lg oral) and
    concerned 35.4% of patients. But other protocols were given
    (mifepristone 600 or 200 mg in association with misoprostol
    800 lg) for respectively 23.4% and 13.5%. Gemeprost
    prostaglandin was used by 1.4% of patients only.
    Eighty-one percent of patients attended the follow-up visit
    3 weeks after inclusion. There was no ongoing pregnancy although
    10% of patients were lost to follow-up. Successful abortion rate
    was 94.4%, 5.6% of patients requiring a secondary surgical
    procedure. Seventeen serious adverse events (1.1%) were reported
    (mainly major bleeding).
    Conclusion: Although a relatively wide range of therapeutic
    strategies in MToP, this study emphasises a satisfactory success
    rate of 95% strongly consistent with the literature.