NEW YORK (Reuters Health) – Preemptive ibuprofen treatment reduces the need for additional pain relief during medically induced abortion, without affecting success rates, an Israeli group reports in Fertility and Sterility online January 20.
“We believe that the fact that most of the women who received preemptive analgesia did not ask for additional pain relief is a strong indicator of improved comfort and less pain and will likely allow more patients an easier choice favoring the less-invasive medical abortion protocol,” the authors state.
Dr. Daniel S. Seidman and colleagues at Chaim Sheba Medical Center, Tel-Hashomer, explain that pain is an important factor for women deciding on surgical or medical abortion, but NSAIDs have been avoided during medical abortion because of the potential for inhibiting prostaglandin-induced uterine contractions.
Having previously shown that ibuprofen is effective when administered at the onset of pain in this setting, the team tested its ability to reduce pain preemptively in a double-blind, randomized trial involving 61 women undergoing first-trimester termination of pregnancy.
The participants received mifepristone followed by misoprostol 2 days later, at which point they were randomly assigned to receive 800 mg ibuprofen or placebo.
Additional analgesia was required by 38% of the ibuprofen group compared with 78% of the placebo group (p<0.001), the investigators found. In fact, 15.5% of women given ibuprofen reported no pain, compared with 5.2% of those in the placebo group.
On logistic regression, the need for additional analgesia was associated with prior history of menstrual pain, according to the report.
The success rate of the medical abortion protocol was not significantly different between the ibuprofen and placebo groups at 82.8% and 87.5% (p=0.72), Dr. Seidman and colleagues report.
“We are aware of the limited size of our study sample,” they write in discussing the findings. “However, our results do suggest that it may be appropriate to offer a woman who is about to undergo medical abortion preemptive use of ibuprofen, especially if she is at increased risk for experiencing severe pain or strongly afraid of a potentially painful procedure.”
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