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Abstract Objective: To assess the efficacy and safety of medical abortion for terminated pregnant at 10-14 gestational weeks of women with chronic Hepatitis B. Methods: A retrospective study was conducted. From January 2013 to December 2017, 40 pregnant women with chronic Hepatitis B at 10-14 gestational weeks in Beijing You’an hospital of capital medical university were included in observation group, whose transaminase (ALT) level had elevated ranging from 2-10 ULN, and when their ALT level decreased to ≤2ULN after given antiviral and liver protection treatment, these women had experienced medical abortion by mifepristone combined with misoprostol voluntarily. At the same period, another 80 pregnant women with chronic Hepatitis B were selected into control group, whose ALT level were normal, and they also had experienced medical abortion by mifepristone combined with misoprostol voluntarily. The ratio of complete abortion, the change of ALT after abortion and the incidence of adverse events were compared between the two groups. Results: There was no statistical significant difference in the age of women, the frequency of gravida and para of women, gestational weeks, and PTA between the two groups. The positive rate of E antigen, amount of HBV-DNA load and ALT level of women at the first visited hospital in observation group were significant higher than those of women in control group. The success rate of abortion had no significant difference between the two groups (P>0.05). After abortion, the rate of abnormal ALT level of women in observation group (40%) were significant higher than that (2.5%) of women in control group (P<0.05), and all women with abnormal ALT had recovered health after treatment continually. There was no significant difference in other incidence of adverse events between the two groups. 55.6% (10/18) women with ALT value equal to or over 3ULN when the first visited hospital in observation group had ALT value over 2ULN after abortion, which was higher than that of women with ALT value less than 3ULN (27.3%, 6/22), but there was no significant difference(P>0.05). Conclusion: Mifepristone combined with misoprostol for terminated pregnant at 10-14 gestational weeks of women with chronic Hepatitis B is safe and effective, however, the high risk factors should be evaluated before abortion, and pregnant women with chronic Hepatitis B and ALT level elevated should be given treatment of liver protection and antiviral. Pregnant women with ALT value equal to or over 3ULN should select artificial abortion method cautiously.
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