RU-486 plus prostaglandins remains the most effective nonsurgical abortion method

The most common medical approach to terminating early pregnancy — the drug RU-486 plus prostaglandins — remains the most effective nonsurgical abortion method, according to a new research review.

The analysis of six studies, led by Dr. Lale Say of the World Health Organization, notes that “failed abortion is an infrequent but important complication” of using medical techniques compared to surgical vacuum aspiration.

Efficacy rates in individual trials range from 76 percent to 97.2 percent for medical abortions compared with 94 percent to 100 percent for surgical methods. In addition, duration of bleeding seems to be longer with medical methods, and they may also be more painful.

Medical abortion methods used in the studies were RU-486 plus prostaglandins, RU-486 alone, prostaglandins alone and methotrexate plus prostaglandins. RU-486 alone had the lowest success rate of the medical methods, and the rate of failed abortions was also significantly higher in the prostaglandin-only group compared to surgery.

The review combines evidence from five randomized controlled trials in Sweden, Denmark, the United Kingdom and the United States, plus one conducted by the World Health Organization. The international trial included 12 centers in India, Vietnam, Slovenia, Zambia, China, Sweden, and Hungary.

The authors report that the trials have small sample sizes, and the results of the review are often based on one trial only. They call for additional trials to evaluate efficacy, side effects, and women’s preferences among medical and surgical first-trimester abortion methods.