Success Rate of Mifepristone Combined with Misoprostol in Termination of Unwanted Pregnancy at Vachira Phuket Hospital

Abstract

Background: Unintended pregnancy is a major public health and social issue with significant physical, psychological, and socioeconomic consequences. Medical abortion using mifepristone in combination with misoprostol is a well-established and highly effective method; however, evidence in the Thai context remains limited, particularly following the amendment of the Criminal Code Section 305.

Objective: To evaluate the effectiveness of mifepristone combined with misoprostol for termination of unintended pregnancy, and to identify factors associated with incomplete abortion and adverse effects.

Materials and Methods: This retrospective cohort study reviewed medical records of women aged 15–50 years with gestational age ≤12 weeks who underwent medical abortion with oral mifepristone 200 mg followed by sublingual misoprostol 800 μg at Vachira Phuket Hospital. A total of 126 cases were included Between June 2024 to March 2025

Results: The complete abortion rate was 78.6%. Multivariate analysis demonstrated that lower educational attainment (secondary school vs. bachelor’s degree or higher: adjusted OR 4.4, 95% CI 1.19–16.29) and partner’s age ≥30 years (adjusted OR 5.52, 95% CI 1.04–29.12) were significantly associated with incomplete abortion. Most patients (76.2%) reported only one adverse effect, with lower abdominal cramping being the most common (65%) and no serious complications requiring hospitalization were observed.

Conclusion: A single regimen of mifepristone 200 mg followed by misoprostol 800 μg achieved a complete abortion rate of 78.6% among women with gestational age ≤12 weeks. Educational level and partner’s age were significantly associated with incomplete abortion. The regimen was generally safe with no severe adverse events. Tailored counseling and consideration of repeat misoprostol dosing may enhance treatment effectiveness in clinical practice.