1st trimester: Medication (Induction) |
- Regimens: Mifepristone 200 mg plus misoprostol 800 mcg or misoprostol only
- Typically used up to 11 weeks gestational age
- Vaginal bleeding begins 1–4 hours after medication administration, with pregnancy expulsion occurs 3–8 hours after medication administration
- Side effects can include abdominal cramping, vaginal bleeding, brief low-grade fever, headache, dizziness, nausea, vomiting, and diarrhea
- Efficacy approximates 95–98%
- Higher complication rate due to risk of failure and retained tissue
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1st trimester: Uterine aspiration |
- Procedure includes dilation of the cervix, insertion of a cannula into the uterine cavity, and aspiration of uterine contents
- Cervical ripening agent (e.g., misoprostol) can be used
- Used up to 14 weeks gestation
- Efficacy approximates 99%
- Typically requires local anesthesia and/or sedation
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2nd trimester: Medication (Induction) |
- Regimens: misoprostol (most common), mifepristone, misoprostol and mifepristone, oxytocin, carboprost, sulprostone
- Allows for expulsion of intact fetus
- Higher risk of complications compared to interventional measures, including hemorrhage and retained products
- Approximately 8–10% of cases require intervention for further removal
- May require 24 hours or longer before pregnancy expulsion is completed
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2nd trimester: Dilation and evacuation |
- Account for the majority of second-trimester abortions
- Short procedure time (<30 minutes once cervix is dilated)
- Higher efficacy rates compared to second-trimester medical abortions
- Risk of uterine perforation
- Prophylactic antibiotics are administered
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