Introduction: voluntary termination of pregnancy (VTP) is legally regulated and permitted virtually in all the countries of the European Union. Spanish Organic Law 2/2010, of 3rd of March, on sexual and reproductive health of voluntary termination of pregnancy offers a new scenario in VTP care, which can be performed at the request of the woman within the first fourteen weeks of gestation or as a result of medical reasons at different weeks of gestation. In Catalonia, 26,932 legal abortions were carried out in 2008. Methodology: a systematic review of the literature on the efficacy and safety of pharmacologically-induced VTP with mifepristone up to 49 days of gestation has been performed. The main bibliographic databases have been reviewed and 33 randomised clinical trials and 7 systematic reviews of the literature have been included in this assessment. Results: the different studies confirm the efficacy of pharmacologically-induced VTP with mifepristone, which achieves complete abortion in 94-96% of cases; the combination of mifepristone and misoprostol being more effective than mifepristone alone (RR 3.76; CI 95% 2.30 to 6.15). Misoprostol can potentially induce foetal malformations, which makes it essential to terminate the pregnancy. In addition, a series of complications caused by pharmacologically-induced VTP have been reported such as anemia (3% of medical VTPs), urinary tract infections (<0.21%), pain, nausea, vomiting, and shivering, among others. Also of note is the importance of a diagnosis in women beyond their 5th week of pregnancy in order to exclude an ectopic pregnancy, as pharmacologically-induced VTP is contraindicated in these cases. An approximation of the costs of pharmacologically-induced VTP vs surgical VTP has also been carried out, showing that the costs of pharmacologically-induced VTP are lower than those of surgical VTP. Conclusions: in conclusion, pharmacologically-induced VTP with mifepristone and misoprostol is effective and safe but it does require an adequate diagnosis of pregnancy and its termination in order to ensure safety.
Voluntary termination of pregnancy; VTP pharmacological; Abortion
Sunyer B, Solà-Morales O. Interrupció farmacològica voluntària de l’embaràs. Barcelona: Agència d’Informació, Avaluació i Qualitat en Salut; 2011.
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