Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy
Abstract Introduction The administration of mifepristone, followed by misoprostol, is widely used for medical abortion. Many studies have demonstrated home abortion to be safe in pregnancies up to 63 days of gestation, and recent data support its safety when extended to more advanced pregnancies. We...
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Wiley
2023-05-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14549 |
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| author | Volodymyr Podolskyi Kristina Gemzell‐Danielsson Lena L. Maltzman Lena Marions |
| author_facet | Volodymyr Podolskyi Kristina Gemzell‐Danielsson Lena L. Maltzman Lena Marions |
| author_sort | Volodymyr Podolskyi |
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| description | Abstract Introduction The administration of mifepristone, followed by misoprostol, is widely used for medical abortion. Many studies have demonstrated home abortion to be safe in pregnancies up to 63 days of gestation, and recent data support its safety when extended to more advanced pregnancies. We studied the efficacy and acceptability of home use of misoprostol up to 70 days of gestation in a Swedish setting and compared the outcomes between pregnancies with a gestational age of up to 63 days and pregnancies with gestational age 64–70 days. Material and methods This prospective cohort study was performed between November 2014 and November 2021 at Södersjukhuset and Karolinska University Hospital, Stockholm, and some patients were also recruited from Sahlgrenska University Hospital, Göteborg and Helsingborg Hospital. The primary outcome was the rate of complete abortions and was defined as complete abortion without any need for surgical or medical intervention and assessed by clinical assessment, pregnancy test and/or vaginal ultrasound. Secondary objectives were assessed by daily self‐reporting in a diary and included pain, bleeding, side effects and women's satisfaction and perception of home use of misoprostol. A comparison of categorical variables was made with Fisher's exact test. The significance level was set to a p‐value ≤0.05. The study was registered at Clinicaltrials.gov on July 14, 2014 (NCT02191774). Results During the study period we enrolled 273 women opting for medical abortion with home use of misoprostol. In the early group, up to 63 days of gestation, 112 women were included with a mean gestational length of 45 days and in the late group, 64–70 days of gestation, 161 women with a mean gestations length of 66.3 days were included. Complete abortion occurred in 95% (95% CI 89–98) of women in the early group and in 96% (95% CI 92–99) in the late group. No differences were found regarding side effects and acceptability was similarly high in both groups. Conclusions Our results show high efficacy and acceptability of medical abortion when misoprostol is administered at home up to 70 days of gestation. This supports previous findings about maintained safety when misoprostol is administered at home even past a very early pregnancy. |
| format | Article |
| id | doaj-art-affc896ce7a04aef86a8f1afc0bb1784 |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-affc896ce7a04aef86a8f1afc0bb17842025-08-20T03:30:56ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-05-01102554154810.1111/aogs.14549Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancyVolodymyr Podolskyi0Kristina Gemzell‐Danielsson1Lena L. Maltzman2Lena Marions3Department of Women's and Children's Health Karolinska Institutet Stockholm SwedenDepartment of Women's and Children's Health Karolinska Institutet Stockholm SwedenDepartment of Obstetrics and Gynecology Södersjukhuset Stockholm SwedenDepartment of Obstetrics and Gynecology Södersjukhuset Stockholm SwedenAbstract Introduction The administration of mifepristone, followed by misoprostol, is widely used for medical abortion. Many studies have demonstrated home abortion to be safe in pregnancies up to 63 days of gestation, and recent data support its safety when extended to more advanced pregnancies. We studied the efficacy and acceptability of home use of misoprostol up to 70 days of gestation in a Swedish setting and compared the outcomes between pregnancies with a gestational age of up to 63 days and pregnancies with gestational age 64–70 days. Material and methods This prospective cohort study was performed between November 2014 and November 2021 at Södersjukhuset and Karolinska University Hospital, Stockholm, and some patients were also recruited from Sahlgrenska University Hospital, Göteborg and Helsingborg Hospital. The primary outcome was the rate of complete abortions and was defined as complete abortion without any need for surgical or medical intervention and assessed by clinical assessment, pregnancy test and/or vaginal ultrasound. Secondary objectives were assessed by daily self‐reporting in a diary and included pain, bleeding, side effects and women's satisfaction and perception of home use of misoprostol. A comparison of categorical variables was made with Fisher's exact test. The significance level was set to a p‐value ≤0.05. The study was registered at Clinicaltrials.gov on July 14, 2014 (NCT02191774). Results During the study period we enrolled 273 women opting for medical abortion with home use of misoprostol. In the early group, up to 63 days of gestation, 112 women were included with a mean gestational length of 45 days and in the late group, 64–70 days of gestation, 161 women with a mean gestations length of 66.3 days were included. Complete abortion occurred in 95% (95% CI 89–98) of women in the early group and in 96% (95% CI 92–99) in the late group. No differences were found regarding side effects and acceptability was similarly high in both groups. Conclusions Our results show high efficacy and acceptability of medical abortion when misoprostol is administered at home up to 70 days of gestation. This supports previous findings about maintained safety when misoprostol is administered at home even past a very early pregnancy.https://doi.org/10.1111/aogs.14549abortionsacceptancefirst trimesterhome usemedical abortionmifepristone |
| spellingShingle | Volodymyr Podolskyi Kristina Gemzell‐Danielsson Lena L. Maltzman Lena Marions Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy Acta Obstetricia et Gynecologica Scandinavica abortions acceptance first trimester home use medical abortion mifepristone |
| title | Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| title_full | Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| title_fullStr | Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| title_full_unstemmed | Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| title_short | Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| title_sort | effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy |
| topic | abortions acceptance first trimester home use medical abortion mifepristone |
| url | https://doi.org/10.1111/aogs.14549 |
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