Vorachart Meevasana, MD¹, Sakol Manusook, MD², Densak Pongrojpaw, MD², Athita Chanthasenanont, MD², Kornkarn Bhamarapravatana, PhD³, Komsun Suwannarurk, MD²

Objective: To evaluate the efficacy, side effects, and cause of termination of pregnancy (TOP) intent of mifepristone and misoprostol combination (MMC) among participants who attended the TOP program.

Materials and Methods: This retrospective study was conducted at the Department of Obstetrics and Gynecology at Phimai Hospital (PH), Nakhon Ratchasima Province, Ministry of Public Health, Thailand and PH affiliated clinic between 2021 and 2024. Participants were pregnant women who attended the TOP with gestational age equal or less than 20 weeks. Forty-eight hours after the first dose of mifepristone, all were evaluated every three hours, and a repeated dose of 400 μg misoprostol was given. Uterine evacuation was performed to complete TOP at 48 hours if ultrasound showed incomplete termination.

Results: Four thousand six hundred ninety-one subjects were recruited. There were 3,862 and 829 cases in adult, 18 years and older, and teenage, younger than 18 years, respectively. Teenage group had more gestation age than adult group, while the complication rates were comparable at 17.9 versus 14.4 weeks and 9.0% versus 6.7% (p<0.001). Both groups preferred to undergo TOP at affiliated clinics rather than at the main hospital, at 82.3% and 73.0%, for adult and teenage groups, respectively. Reason for TOP of adult and teenage groups were financial issues at 99.9% and 98.2%, and ongoing education at 10.2% and 58.7% with statistical significance. The complete expulsion rates in the adult and teenage groups were 39.6% and 56.4%, respectively (p<0.001).

Conclusion: MMC was safe and effective for TOP in second trimester pregnant women.

Received 22 September 2025 | Revised 16 December 2025 | Accepted 18 December 2025

DOI: 10.35755/jmedassocthai.2026.1.03508