Comparison of groups with medical and surgical terminations of pregnancy

Abstract

Objective: The aim of this study was to compare two cohorts of subjects who underwent termination of pregnancy up to 49 days of amenorrhoea by medical (pharmacological) termination (faUUT) and surgical instrumental termination of pregnancy (inUUT).

Design: Prospective clinical study.

Setting: Department of Gynecology and Obstetrics, Charles University in Prague, 1st Faculty of Medicine, Hospital Na Bulovce.

Methods: From August 2014 to July 2017, a total of 838 terminations of pregnancy up to 49 days of amenorrhoea were performed at our department. Altogether 474 of subjects underwent faUUT and inUUT was performed in 364 of women. We compared the anamnestic, sociodemographic, and health characteristics of women and we evaluated the efficacy, required medical interventions, medication use, the number and characteristics of complications in both groups.

Results: Women who underwent faUUT, were fewer with previous delivery (40.9% vs. 75.0%; p < 0.001), but they had more often previous artificial termination of pregnancy (27.8% vs. 19.5%; p = 0.003). The total number of outpatient visits was significant different between both cohorts, both in median (4 vs 1; p < 0.001) and arithmetic mean (3.8 vs. 1.2; p < 0.001). The usage of uterotonics was much higher in faUUT group (25.7% vs. 8.2%; p < 0.001). On the other side, the antibiotic use was similar in both groups (3.2% vs. 4.4%; p < 0.17). The surgical intervention (revisio cavi uteri instrumentalis, RCUI) required after termination of pregnancy was performed in 7.4% of faUUT cases and in 3.0% of inUUT group (p < 0.001). The failure of faUUT was found in 2 (0.4%) subjects.

Conclusion: The complications and other followed parameters were various between both groups. Medical termination of pregnancy is a safe method with some potential non life-threatening complications.

Keywords: complications efficacy.; first trimester; medical termination of pregnancy; surgical termination of pregnancy.