Objective: To assess the safety of mifepristone in combination with misoprotol for medical abortion.
Method: Literatures on the safety of medical abortion were searched in 9 databases worldwide and 9 Chinese medical journals.
Results: A total of 101 articles and 1364 women were collected. Severe side effects including allergic or hemorrhagic shock, arrhythmia, convulsion and newborn deformities were observed in 115 cases. A total of 1015 cases appeared vaginal bleeding, mild or moderate allergic reaction. Systematic review found the relative risks (95% confidence interval, CI) of bleeding, abdominal pain, fever and dizziness in the medical abortion population were 3.27 (1.14 - 9.38), 1.63 (1.14 - 2.34), 1.58 (1.03 - 2.44) and 1.36 (1.06 - 1.75), respectively. These were higher in the medical abortion population than that in the surgical abortion population. In addition, the duration of bleeding caused by medical abortion was longer than that caused by surgical abortion. Its weighted mean difference was 6.49 and 95% CI was 6.08 - 7.80.
Conclusions: The incidence of side effects caused by this medical abortion was low. However, attention should be paid in clinical practice to the rare, but severe adverse events caused by this treatment. It is necessary to establish a comprehensive nationwide reporting system for these adverse events.
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