Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia

Abstract   Objectives: The aim of the study was to assess the efficacy and acceptability of a regimen using mifepristone and buccal misoprostol with unlimited dosing for second trimester abortion in Armenia.   Results: A total of 120 women with a median gestational age of 18 weeks participated in the study. All women began misoprostol induction around 24 hours after taking mifepristone. Complete uterine evacuation was achieved in 119 (99.2%) women. The median induction-to-abortion interval was 10.3 hours (range 4–17.4) with a mean of 9.5 ± 2.5 hours. A median of four misoprostol doses (range 2–6) with a mean of 4 ± 1 misoprostol doses was administered. The induction-to-abortion interval, number of misoprostol doses, pain score and analgesia use increased as gestational age advanced. Acceptability of the method was high among both patients and providers.   Conclusion: The medical abortion regimen of 200 mg mifepristone followed 24 hours later by induction with 400 μg buccal misoprostol administered every 3 hours, with no limit on the number of doses used for the termination of pregnancies of 13–22 weeks’ gestation is an effective and acceptable option for women.