Acceptability of home use of mifepristone for medical abortion
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Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion (EMA) up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women (67%) aged 20-30 years old,22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol,4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion,7.2% incomplete abortion and 0.7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d (7 weeks) and two doses of misoprostol between 49 d and 63 d (7-9 weeks) of pregnancy.
Medical abortion
Incomplete Abortion
Abortifacient
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In India about 6.7 million abortions takes place every year of which 4 million are induced and 2 millions are spontaneous. WHO estimates that unsafe abortion kills about 70,000 women annually, many more suffer serious injuries and permanent disability. In spite of legalization of medical termination of pregnancy in India, the incidence of illegal abortion is at time more common than legal abortion. Unsafe abortion is major cause of mortality among women in India accounting for 12% of all maternal death. One way of reducing mortality and morbidity associated with unsafe abortion is early decision by women for termination of pregnancy by use of combination of mifepristone and misoprostol for termination of pregnancy up to 9 weeks. So the present study aims to study the efficacy of mifepristone and misoprostol for medical termination of pregnancy up to 9 weeks of pregnancy. This is a prospective randomized study undertaken in 100 patients seeking MTP, in the reproductive age group with a history of less than or equal to 9 weeks gestation, attending Obstretic and Gynace OPD of Sir Takhsinhji Hospital attached to Govt. Medical College, Bhavnagar from March 2018 to August 2019. They were administered 200 mg of mifepristone followed by oral misoprostol 400 ug after 48 hours and another 400ug misoprostol after 24 hours. Results show Overall success rate of 92% abortion failure rate of 8% were achieved. This treatment regimen was more effective in earlier gestational age group.
Keywords: Abortion, MTP, Mifepristone , Misoprostol
Medical abortion
Products of conception
Abortifacient
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To examine the acceptability and feasibility of early medical abortion using mifepristone and misoprostol in Azerbaijan.A total of 863 women in Baku and two regions of Azerbaijan who sought termination of gestations up to 63 days were enrolled in the study. In the capital, women swallowed 200 mg mifepristone in the clinic and were given the option of taking 800 μg misoprostol buccally either at the clinic or at home 24-48 hours later. In the regions, women were given the option of taking both drugs at home. Follow-up visits were to take place two weeks after mifepristone administration to determine abortion status.Seventy-four percent of women in the regions chose home administration of mifepristone, and 92% of women from all locations selected misoprostol home administration. Ninety-seven percent of women had complete abortions, and 97% were satisfied or very satisfied with the method. The vast majority of participants preferred medical abortion for a future procedure (96%). Nearly all women (98%) would recommend medical abortion for pregnancy termination to a friend.Mifepristone-misoprostol medical abortion with the option of home administration of both drugs is an acceptable and feasible option for women in Azerbaijan.
Medical abortion
Abortifacient
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Medical abortion
Products of conception
Incomplete Abortion
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Objective To assess the outcome of a regimen of a reduced dose of mifepristone followed by one or two doses of vaginal misoprostol as a non-surgical method for termination of pregnancy. Design Prospective observational study. Setting Aberdeen Royal Infirmary, Aberdeen, Scotland. Population Women seeking abortion under the 1967 Abortion Act. Methods Factors influencing the outcome in a consecutive series of 4132 women undergoing early medical abortion in one Scottish teaching hospital since 1994. Main outcome measures Complete abortion rates following one or two doses of misoprostol. The effect of age, gestation, previous pregnancy and previous termination on complete abortion rates following the medical regimen. Results Of the 4132 women, 95 (2.3%) aborted within 48 hours of mifepristone and a further 3942 (95.4%) achieved complete abortion following administration of one or two doses of misoprostol. Thus, the overall complete abortion rate was 97.7% (4037/4131). A total of 94 (2.3%) women required surgical intervention of whom 13 (0.3%) had a continuing pregnancy. Following change of the regimen to include the possibility of two doses of misoprostol the continuing pregnancy rates were significantly reduced (OR = 5.88) and gestation ceased to have an effect on overall efficacy. Women who had a previous abortion were more likely to have a failed medical abortion (OR = 2.09), while women with no previous termination, but a previous live birth were more likely to have a failed abortion (OR = 2.03). Conclusion Mifepristone in combination with one to two doses of vaginal misoprostol is an effective regimen for early medical abortion. The option of administering two doses of misoprostol significantly reduced the ongoing pregnancy rates and abolished the effect of gestation on overall efficacy. Previous termination was the strongest predictor of failed medical abortion.
Medical abortion
Regimen
Vacuum aspiration
Abortifacient
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Medical abortion
Abortifacient
Incomplete Abortion
Early Pregnancy Loss
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To assess the outcome of a regimen of a reduced dose of mifepristone followed by one or two doses of vaginal misoprostol as a non-surgical method for termination of pregnancy.Prospective observational study.Aberdeen Royal Infirmary, Aberdeen, Scotland.Women seeking abortion under the 1967 Abortion Act.Factors influencing the outcome in a consecutive series of 4132 women undergoing early medical abortion in one Scottish teaching hospital since 1994.Complete abortion rates following one or two doses of misoprostol. The effect of age, gestation, previous pregnancy and previous termination on complete abortion rates following the medical regimen.Of the 4132 women, 95 (2.3%) aborted within 48 hours of mifepristone and a further 3942 (95.4%) achieved complete abortion following administration of one or two doses of misoprostol. Thus, the overall complete abortion rate was 97.7% (4037/4131). A total of 94 (2.3%) women required surgical intervention of whom 13 (0.3%) had a continuing pregnancy. Following change of the regimen to include the possibility of two doses of misoprostol the continuing pregnancy rates were significantly reduced (OR = 5.88) and gestation ceased to have an effect on overall efficacy. Women who had a previous abortion were more likely to have a failed medical abortion (OR = 2.09), while women with no previous termination, but a previous live birth were more likely to have a failed abortion (OR = 2.03).Mifepristone in combination with one to two doses of vaginal misoprostol is an effective regimen for early medical abortion. The option of administering two doses of misoprostol significantly reduced the ongoing pregnancy rates and abolished the effect of gestation on overall efficacy. Previous termination was the strongest predictor of failed medical abortion.
Medical abortion
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Abortifacient
Vacuum aspiration
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Background: Medical abortion with mifepristone and misoprostol was introduced in Norway in 1998, and since then there has been an almost complete change from predominantly surgical to medical abortions. We aimed to describe the medical abortion implementation process, and to compare characteristics of women obtaining medical and surgical abortion.
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To evaluate medical abortion effectiveness and safety in women at 13 or more weeks gestation provided care through Women on Web's telemedicine service.We conducted a retrospective case study of abortions at 13 or more weeks gestation provided by Women on Web between 2016 and 2019. Women received mifepristone and misoprostol or misoprostol alone for abortion. We extracted demographic characteristics and outcome data for cases with pregnancy continuation outcomes.We identified 144 women who used medical abortion at 13 or more weeks; 131 (91%) provided abortion outcome data. Almost all, 118 (90%) received mifepristone and misoprostol. The population had an average age of 26 ± 5.8 years, 102 (78%) reported a gestational age of 13 to 15 weeks, 114 (87%) had experienced prior pregnancy, and represented all world regions. Overall, 13 (10%) women reported a continuing pregnancy, with 5 (5%) among women 13 to 15 weeks and 8 (28%) among those ≥16 weeks (p = 0.001); 38 (29%) reported adverse events (heavy bleeding, fever), 53 (43%) sought additional care from a health provider, and 18% of all cases received treatment with D&C/aspiration.Efficacy of self-administered medical abortion decreases as gestational age increases, risking continuation of pregnancy. Provision through telemedicine at 13 to 15 weeks appears safe and effective.Limited data suggest that medical abortion through telemedicine services may be a safe option through 15 weeks gestation in settings where there is ready access to the formal health system. More research with adequate sample sizes and high rates of follow-up is needed to inform on the safety of telemedicine for pregnancies 13 weeks and greater.
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Medical abortion
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