Acceptability and feasibility of outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation in Singapore

Abstract

Objectives: The aim of the study was to examine the acceptability and feasibility of using a combined regimen of 200 mg mifepristone and 800 μg buccal misoprostol in an outpatient abortion service in Singapore, where mifepristone is not currently registered.

Study design: The pilot prospective study enrolled 130 women who sought termination of pregnancies up to 70 days gestation at two public hospitals in Singapore. Women received 200 mg mifepristone to take at the clinic or at home, followed 24 h later by 800 μg buccal misoprostol administered at home. A follow-up visit was scheduled seven to ten days after mifepristone to confirm the outcome of the abortion. The primary outcome was rate of successful abortion and secondary outcomes were women's preference for location of mifepristone administration and satisfaction with the method.

Results: The large majority of women (96.8%) had successful abortions without recourse to surgical intervention. Most women (88.2%) chose to take mifepristone at the clinic. Most women reported the side effects as acceptable (68.3%) or neutral (26.0%). Almost all women (94.4%) were very satisfied or satisfied with the method.

Conclusions: Outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation is acceptable and feasible and has the potential to expand available options in Singapore.

Keywords: Medical abortion; Mifepristone; Misoprostol; Singapore.