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Objectives: To assess the differences in the medical management of therapeutic abortion using Mifepristone plus Misoprostol compared to the use of Misoprostol alone. Materials and methods: An observational, retrospective and multicenter cohort study (National Maternal Perinatal Institute [INMP], Pucallpa Regional Hospital, Santa Rosa de Piura Hospital and Loreto Regional Hospital) was conducted in pregnant women with indication of therapeutic abortion, according to as established in MRI No. 4862014-MINSA. Patients enrolled in the INMP, upon admission they received 200 mg of Mifepristone and at 24 hours Misoprostol 800 μg placed in the bottom of the vaginal sac after the cervix, followed by 400 μg sublingually , every 3 hours until the expulsion of the fetus and placenta, the cap being 5 doses per day; the patients of the three remaining hospitals were administered only Misoprostol under the same scheme. Results: The expulsion time of the fetus was considered from the administration of the first dose of misoprostol until 24 hours; in the Mifepristone plus Misoprostol group it was 100% and in the Misoprostol group it was only 83% (p = 0.05). The expulsion of the placenta in the group that used Mifepristone was 96% and in the Misoprostol group it was only 83% (p = 0.20). Endouterine remains were present in 10% of the mifepristone group versus 33% of the misoprostol-only group (p = 0.03). The expulsion time of the product of conception was shorter in the mifepristone group with a difference of their medians of 2.8 hours (p = 0.001). Conclusions: We found that there are differences in the medical management of therapeutic abortion in favor of the use of Mifepristone plus Misoprostol versus the use of Misoprostol alone, in terms of success rate, induction time to abortion and adverse reactions or complications.

Estudio comparativo en el manejo médico del aborto terapéutico entre el uso de mifepristone más misoprostol y el uso de misoprostol solo