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CME Credit Offered
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Poster Session 1

(303) Pregnancy termination outcomes in singletons with fetal anomaly using mifepristone and misoprostol versus misoprostol alone.

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Mifepristone (MIFE) and misoprostol (MISO) in combination has been shown to be more effective for induction terminations than MISO alone in the general population, however outcome data specific to singleton pregnancies with fetal anomaly or genetic disorder is lacking. Here, we compare the effectiveness and safety of the two regimens in this subpopulation. 

Study Design: We conducted a retrospective cohort study in 66 induction terminations of singleton pregnancies with fetal anomaly between 2009-2023 at a single tertiary medical center. Induction characteristics and maternal outcomes were compared between inductions using MISO and MIFE (N=45, 68%) versus MISO alone (N=21, 32%).

Results: There was no significant difference in incidence of infection, post-partum hemorrhage, retained products requiring dilation and curettage (D&C) and six-week readmission; or median in induction duration, estimated blood loss and antibiotic duration. When stratified by early versus late gestational age (GA) at the time of induction (defined in relation to the median of 24w0.5d), a significant reduction in induction duration was found amongst patients who received both MIFE and MISO versus MISO alone only in the earlier gestational age strata.  

Conclusion: The addition of MIFE is safe and has a trend to expedite termination induction when compared to MISO alone, although we did not observe a significance in outcome measures likely due to small sample size. The significant decrease in induction duration seen in the patients who received both MIFE and MISO in the earlier GA stratum supports that MIFE may have stronger effect on reducing induction duration when used earlier in pregnancy. Single center data and rarity of cases were main limitations. A multicenter or state database should be used to further validate findings.