Table 2.

Comparison of Mifepristone Followed by Misoprostol for Management of Medication Abortion Versus Early Miscarriage

	Medication abortion	Miscarriage
Day 1 (in office)
History	• Confirm last menstrual period correlates to GA less than 70 days (ultrasound only needed if concern for ectopic pregnancy or uncertain GA) • Counseling about pregnancy options	• Ultrasound to confirm diagnosis • Counseling about miscarriage management options
	• Exclude contraindications (Box 2)
Exam	• Pelvic examination only considered if concern for ectopic pregnancy or uncertain GA
Lab	• ± Baseline quantitative serum hCG for comparison at follow-up visit • ± Hemoglobin if concern for anemia • ± STI testing if risk factors identified
Informed consent	• Ensure patient understands the process, alternatives, risks, and benefits • Required: sign manufacturer’s Patient Agreement Form (available at earlyoptionpill.com) • Dispense mifepristone 200 mg PO × 1
Day 2+ (at home)
Patient initiates	Take 800 mcg misoprostol buccally or vaginally 24–72 h after taking mifepristone	Take 800 mcg misoprostol vaginally 24–72 h after taking mifepristone
	• Ibuprofen 600 mg every 6 h as needed for cramping and pain • Counsel patient on concerning symptoms and return precautions that would require urgent evaluation (Box 2)
Days 5–14
History	• Assess bleeding and symptoms consistent with passed pregnancy and resolution of pregnancy symptoms • Identify if any concerning symptoms are present (Box 2)
Lab	• Quantitative serum hCG should decline 50% by 3 days after medication abortion and 80% by 7 days49, 50 • Ultrasound rarely indicated (e.g., concern for ectopic, ongoing pregnancy)

GA gestational age, hCG human chorionic gonadotropin, STI sexually transmitted infection