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FDA approval of mifepristone (RU-486) for early medical abortion in 2000 has led to an increasing number of medical rather than surgical abortions in the U.S. Are medical abortions associated with the same subsequent adverse pregnancy outcomes as surgical abortions? To address this question, investigators analyzed nationwide data of all women in Denmark who underwent abortions for nonmedical reasons between 1999 and 2004.
A total of 2710 women had first-trimester medical abortions, and 9104 had surgical abortions. After adjustment for numerous potential confounders, cohabitation with a partner or not, and urban or rural residence, medical abortion was not associated with significantly increased risks for subsequent ectopic pregnancy, spontaneous abortion, preterm birth, or low-birth-weight infants.
Virk J et al. Medical abortion and the risk of subsequent adverse pregnancy outcomes. N Engl J Med 2007 Aug 16; 357:648-53.
Comment
As long as induced abortion is available, it will be used by some women who fail to use contraception or have contraceptive failures and do not desire pregnancy. This study indicates that the risks for subsequent adverse pregnancy outcomes are not appreciably different for medical and surgical abortion.