Medical abortion in women with large uterine fibroids: a case series

Women with fibroid uteri seeking surgical abortion often represent a unique challenge. When the uterine cavity is significantly enlarged or distorted making surgical evacuation difficult or impossible, we offer medical abortion using mifepristone followed by misoprostol beyond the standard 63- to 70-day gestational age cutoff that is typically recommended. This case series describes our regimen and outcomes for 6 patients from 10 to 13 weeks gestation underdoing outpatient medical abortion and 6 patients from 14 to 20 weeks gestation undergoing inpatient medical abortion. Three patients required evacuation for retained products and all others had successful medical abortions without complications.