I. Nisand
Speeches:
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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.