Therapeutic abortion is termination of pregnancy for medical indications
Method of Therapeutic Abortion
May be surgical or medical
Surgical:
- After 12 weeks: MVA or EVA
- In 13th–18th week, dilatation and evacuation (D&E) after cervical priming with misoprostrol 400μg for 3 hours.
- D&E should only be performed by skilled and experienced doctors.
Medical:
In 13–22 weeks:
- Give mifepristone 200mg orally, followed after 36–48 hours by misoprostrol 400μg orally every 3 hours for 5 doses.
- Or misoprostrol 400μg orally every 3 hours for 5 doses.
Medication for therapeutic abortion
| Option | Gesta-tional age | Mifepristone Day 1 | Misoprostol | Efficacy | ||
| Dose | Route | Timing | ||||
| Recommended option | Up to 9 weeks | 200mg orally (one 200mg tablet) | 800μg (four 200μg tablets) | Bucally or sub lingually | Day 3 | 95–98% |
| Other options | Up to 9 weeks | 200mg orally (one 200mg tablet) | 800μg (four 200μg tablets) | Vaginally | Day 2 or 3 | 93–97% |
| 200mg orally (one 200mg tablet) | 800μg (four 200μg tablets) Repeat after +7 days if not aborted | Vaginally | 6–24 hours | 95–98% | ||
| Up to 7 weeks | 200mg orally (one 200mg tablet) | 400μg (two 200μg tablets) | Orally | Day 2 or 3 | 89–93% | |
Sources: Ashok, 2002; Britton, 2007; Creinin, 2004; Middleton, 2005; Shannon, 2006; Tang,
2003; von Hertzen, 2003; WHO, 2000.