Prostaglandin-Induced Medical Abortion: Unveiling Complications

Abstract

Background: Abortion is a term used to describe the termination of pregnancy before 22 gestational weeks. There are two methods for terminating pregnancy: medical and/or surgical. In addition to surgical abortion, there is a medical method available, which is believed to be safely performable up to the ninth week of pregnancy and outside of a healthcare facility. Objectives: To investigate the most common complications of medical abortion. Methods: A retrospective study was conducted from March 1, 2023, to April 20, 2023, at the Obstetrics and Gynecology Department of Kaunas Clinics. Patients who had undergone a medical abortion from September 1, 2021, to September 1, 2022, were selected from the clinic's registry. The included patients had ongoing pregnancies up to 22 gestational weeks, with medical indications for pregnancy termination. The study was approved by the Bioethics Center under Approval No. BEC-MF-100 Results: During the study, data from 62 patients were analysed. The participants' ages ranged from 16 to 44 years, with an average age of 30.97 years (SD - 5.890). Throughout the study, we noted the following complications associated with medical abortion using prostaglandins exclusively: incomplete evacuation of pregnancy tissue requirement for an additional dose of misoprostol (64.5%), retained placenta (4.8%), failed abortion necessitating surgical intervention (17.7%), anaemia (37.1%), recurrent heavy genital bleeding (1.6%), and infection (3.2%). In cases of retained placenta, 4.8% of patients received oxytocin, which was effective in 33.3% of these cases. In the remaining 66.7% of women, manual placental removal was performed surgically. Erythrocyte mass transfusion was not required for any patient. None of the patients required erythrocyte mass transfusion. When comparing women for whom medical abortion was successful with those for whom the procedure was unsuccessful and required surgical completion, it was observed that anaemia occurred more frequently after a successful medical abortion (χ2 test = 7.275, p = 0.007). Discussion & Conclusion: The most common complication of medication-induced abortion, when only prostaglandins are administered, is anemia. Anemia tends to develop more frequently following a successful medication-induced abortion than when surgical intervention is performed in cases of unsuccessful medication-induced pregnancy termination.