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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objective The aim of this study was to assess the ability of using beta-human chorionic gonadotropin (β-hCG) serum level as a predictive factor for medical abortion success within 24 h after using misoprostol. Background Serum β-hCG levels decline compared with gestational age when medical abortion is delayed owing to late diagnosis. This makes serum β-hCG more effective in predicting abortion success than gestational age. Kim and colleagues found that β-hCG lower than 40 000 mIU/ml may be a predictive factor of successful abortion within 24 h after misoprostol administration. Patients and methods This is an observational study where serum β-hCG level was measured in 135 women with miscarriage up to 11 weeks of gestational age before offering them medical abortion with misoprostol. Positive outcome of the study was achieving complete abortion without the need of surgical intervention within 24 h of misoprostol administration. Results Among 135 patients treated with misoprostol, 117 (86.7%) patients achieved complete abortion, whereas in 18 (13.3%) patients, the therapy failed. Receiver operating characteristic curve analysis showed that serum β-hCG level more than 32 043 mIU/ml is a good predictive factor for failure of medical abortion within 24 h. It had sensitivity of 76.7%, specificity of 56.5%, with positive predictive value of 73% and negative predictive value of 62% at area under curve of 0.593. Conclusion Women with serum β-hCG less than 32 043 mIU/ml are likely to achieve abortion within 24 h after intravaginal administration of misoprostol.

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