June 12, 2015 — Medication and surgical abortions are equally effective during the first trimester, and both procedures have very low rates of complications, according to a study published last week in Obstetrics & Gynecology, MedPage Today's "The Gupta Guide" reports.
The study analyzed the electronic health records of more than 30,000 women seeking abortion before 64 days of gestation from Planned Parenthood Los Angeles between November 2010 and August 2013. Of these women, 13,221 underwent medication abortion and 16,925 underwent surgical abortion.
The researchers found that medication abortion during the first 64 days of pregnancy had an efficacy rate of 99.6%, while the efficacy rate of surgical abortion during that timeframe was 99.8%, making the methods nearly identical in terms of effectiveness.
The researchers noted that while only 1.9% of patients overall reported adverse events -- such as continued pregnancy, ongoing symptoms or unanticipated aspiration -- medication abortion patients were more likely to report such events than surgical abortion patients.
According to the researchers, only 1.3% of all study participants required unanticipated aspiration to resolve bleeding, pain or continued pregnancy. When divided by procedure, they found that 2.1% of medication abortion patients required surgical follow-up care to complete the abortion or resolve other procedure-related complications, compared with 0.6% of surgical abortion patients.
More specifically, they found that 1.8% of medication abortion patients underwent an unanticipated aspiration to resolve pain or bleeding, compared with 0.4% of those who received surgical abortion. Meanwhile, the study found that only 0.4% of women receiving a medication abortion and 0.1% of surgical abortion patients required unanticipated aspiration for an abortion failure.
According to the study, patient age and gestational age both were found to have an effect on the risk of unanticipated aspiration. The researchers found that the risk of unanticipated aspiration increased by 3% for each year of patient age. Meanwhile, they found that every week of gestational age increased the risk of unanticipated aspiration among women in the medication abortion group, while every week of gestational age decreased the risk for women in the surgical abortion group ("The Gupta Guide," MedPage Today, 6/10).