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Tschann M, Ly ES, Hilliard S, Lange HLH. Changes to medication abortion clinical practices in response to the COVID-19 pandemic. Contraception 2021; 104:77-81. [PMID: 33894247 PMCID: PMC8059330 DOI: 10.1016/j.contraception.2021.04.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To document medication abortion clinical practice changes adopted by providers in response to the COVID-19 pandemic. STUDY DESIGN Longitudinal descriptive study, comprised of three online surveys conducted between April to December, 2020. We recruited sites from email lists of national abortion and family planning organizations. RESULTS Seventy-four sites opted to participate. We analyzed 55/74 sites (74%) that provided medication abortion and completed all three surveys. The total number of abortion encounters reported by the sites remained consistent throughout the study period, though medication abortion encounters increased while first-trimester aspiration abortion encounters decreased. In response to the COVID-19 pandemic, sites reduced the number of in-person visits associated with medication abortion and confirmation of successful termination. In February 2020, considered prepandemic, 39/55 sites (71%) required 2 or more patient visits for a medication abortion. By April 2020, 19/55 sites (35%) reported reducing the total number of in-person visits associated with a medication abortion. As of October 2020, 37 sites indicated newly adopting a practice of offering medication abortion follow-up with no in-person visits. CONCLUSIONS Sites quickly adopted protocols incorporating practices that are well-supported in the literature, including forgoing Rh-testing and pre-abortion ultrasound in some circumstances and relying on patient report of symptoms or home pregnancy tests to confirm successful completion of medication abortion. Importantly, these practices reduce face-to-face interactions and the opportunity for virus transmission. Sustaining these changes even after the public health crisis is over may increase patient access to abortion, and these impacts should be evaluated in future research. IMPLICATIONS STATEMENT Medication abortion serves a critical function in maintaining access to abortion when there are limitations to in-person clinic visits. Sites throughout the country successfully and quickly adopted protocols that reduced visits associated with the abortion, reducing in-person screenings, relying on telehealth, and implementing remote follow-up.
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Affiliation(s)
- Mary Tschann
- Society of Family Planning and Society of Family Planning Research Fund, Denver, CO, United States
| | - Elizabeth S Ly
- Society of Family Planning and Society of Family Planning Research Fund, Denver, CO, United States
| | - Sara Hilliard
- Society of Family Planning and Society of Family Planning Research Fund, Denver, CO, United States
| | - Hannah L H Lange
- Society of Family Planning and Society of Family Planning Research Fund, Denver, CO, United States.
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Bizjak I, Fiala C, Berggren L, Hognert H, Sääv I, Bring J, Gemzell-Danielsson K. Efficacy and safety of very early medical termination of pregnancy: a cohort study. BJOG 2017; 124:1993-1999. [PMID: 28856829 DOI: 10.1111/1471-0528.14904] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the efficacy and safety of medical termination of pregnancy (MTOP) when no intrauterine pregnancy (IUP) is confirmed on ultrasound. DESIGN Retrospective case-note review. SETTING Two gynaecological clinics in Vienna, Austria, and Gothenburg, Sweden. POPULATION All women with gestations of ≤49 days undergoing an MTOP during 2004-14 (Vienna) and 2012-15 (Gothenburg). METHODS Two study cohorts were created: women with and women without a confirmed IUP. An IUP was defined as the intrauterine location of a yolk sac or fetal structure visible by ultrasound. Women with an IUP were selected randomly and included in the IUP cohort. MAIN OUTCOME MEASURES Efficacy of MTOP, defined as no continuing pregnancy and with no need of surgery for incomplete TOP. RESULTS After excluding 11 women diagnosed with an extra-uterine or molar pregnancy, 2643 cases were included in the final analysis; 1120 (98.2%) had a successful TOP in the no-IUP group, compared with 1458 (97.1%) in the IUP group, with a risk difference of 1.09% (95% confidence interval, 95% CI, -0.14, 2.32%; P = 0.077). Significantly more women with confirmed IUP were diagnosed with incomplete TOP, and were treated with either surgery or additional medical treatment of misoprostol [64 (4.3%) versus 21 (1.8%); risk difference -2.42%; 95% CI -3.9, -1.1%; P < 0.001]. CONCLUSIONS There was no difference between the groups in efficacy of MTOP, whereas early treatment resulted in significantly fewer interventions for incomplete TOP. The risk of ectopic pregnancy needs to be considered if treatment is initiated before an IUP is confirmed, but with structured clinical protocols the possibility of the early detection of an ectopic pregnancy in an asymptomatic phase may increase. TWEETABLE ABSTRACT MTOP before confirmed intrauterine pregnancy is as effective as at later gestation with less incomplete TOP.
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Affiliation(s)
- I Bizjak
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - C Fiala
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,GynMed Clinic, Vienna, Austria
| | - L Berggren
- Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Hognert
- Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - I Sääv
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Department of Obstetrics and Gynaecology, Norrtälje Hospital, Norrtälje, Sweden
| | - J Bring
- Statisticon AB, Stockholm, Sweden
| | - K Gemzell-Danielsson
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Blanchard K, Lince-Deroche N, Fetters T, Devjee J, de Menezes ID, Trueman K, Sudhinaraset M, Nkonko E, Moodley J. Introducing medication abortion into public sector facilities in KwaZulu-Natal, South Africa: an operations research study. Contraception 2015; 92:330-8. [DOI: 10.1016/j.contraception.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 11/28/2022]
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LIU HAIYANG, MA WEI, LIU QI, WANG FASHAN, CAO LING, LI TIENAN, ZHANG NING, GENG FANG. Effect of Wujia Shenghua capsule on uterine bleeding following medically-induced incomplete abortion in rats during early pregnancy. Exp Ther Med 2015; 10:635-640. [PMID: 26622367 PMCID: PMC4509024 DOI: 10.3892/etm.2015.2548] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 01/20/2015] [Indexed: 12/14/2022] Open
Abstract
The Wujia Shenghua capsule (WSC) is derived from Sheng-Hua-Tang, a well-known traditional Chinese medicine compound prescription that has been widely applied during the postpartum period in Chinese communities for a number of years. The aim of the present study was to investigate the effect of WSC on uterine bleeding following medically-induced incomplete abortion in rats during early pregnancy. Incomplete abortions were induced in Wistar rats during early pregnancy using mifepristone combined with misoprostol. The effects of WSC treatment were investigated in terms of the duration and volume of uterine bleeding, the uterine index and shape, and various hemodynamic indexes. In addition, blood samples were collected to measure the levels of estradiol (E2), fibronectin (FN) and laminin (LM) via a radioimmunoassay or enzyme-linked immunosorbent assay, while the expression levels of FN, estrogen receptor (ER) and progesterone receptor (PR) in the uterine tissues were determined by immunohistochemistry. The in vivo results demonstrated that WSC treatment markedly shortened the duration and reduced the volume of uterine bleeding when compared with the model group. Furthermore, WSC treatment significantly elevated the E2 level in the serum and the expression of the ER and PR in the uterine tissues, while notably decreasing the FN and LM levels in the serum and uterine tissues. In addition, the hemodynamic indexes were shown to improve with WSC treatment. These results demonstrated that WSC exerted an inhibitory effect on the bleeding caused by medical abortion, possibly through modulating the E2, ER, PR, FN and LM levels.
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Affiliation(s)
- HAIYANG LIU
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - WEI MA
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - QI LIU
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - FASHAN WANG
- Duoduo Pharmaceutical Co. Ltd., Jiamusi, Heilongjiang 154002, P.R. China
| | - LING CAO
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - TIENAN LI
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - NING ZHANG
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P.R. China
| | - FANG GENG
- College of Chemistry and Chemical Engineering, Harbin Normal University, Harbin, Heilongjiang 150025, P.R. China
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Patil E, Edelman A. Medical Abortion: Use of Mifepristone and Misoprostol in First and Second Trimesters of Pregnancy. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-014-0109-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cleland K, Creinin MD, Nucatola D, Nshom M, Trussell J. Significant adverse events and outcomes after medical abortion. Obstet Gynecol 2013; 121:166-71. [PMID: 23262942 PMCID: PMC3711556 DOI: 10.1097/aog.0b013e3182755763] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze rates of significant adverse events and outcomes in women having a medical abortion at Planned Parenthood health centers in 2009 and 2010 and to identify changes in the rates of adverse events and outcomes between the 2 years. METHODS In this database review we analyzed data from Planned Parenthood affiliates that provided medical abortion in 2009 and 2010 almost exclusively using an evidence-based buccal misoprostol regimen. We evaluated the incidence of six clinically significant adverse events (hospital admission, blood transfusion, emergency department treatment, intravenous antibiotics administration, infection, and death) and two significant outcomes (ongoing pregnancy and ectopic pregnancy diagnosed after medical abortion treatment was initiated). We calculated an overall rate as well as rates for each event and identified changes between the 2 years. RESULTS Among 233,805 medical abortions provided in 2009 and 2010, significant adverse events or outcomes were reported in 1,530 cases (0.65%). There was no statistically significant difference in overall rates between years. The most common significant outcome was ongoing intrauterine pregnancy (0.50%); significant adverse events occurred in 0.16% of cases. One patient death occurred as a result of an undiagnosed ectopic pregnancy. Only rates for emergency department treatment and blood transfusion differed by year and were slightly higher in 2010. CONCLUSION Review of this large data set reinforces the safety of the evidence-based medical abortion regimen. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Kelly Cleland
- Office of Population Research, Princeton University, Princeton, New Jersey 08648, USA.
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Goldstone P, Michelson J, Williamson E. Effectiveness of early medical abortion using low-dose mifepristone and buccal misoprostol in women with no defined intrauterine gestational sac. Contraception 2012; 87:855-8. [PMID: 23158804 DOI: 10.1016/j.contraception.2012.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 10/08/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The study was conducted to assess the effectiveness of early medical abortion (EMA) in women with early pregnancy and no defined intrauterine gestational sac (IUGS) on ultrasound. STUDY DESIGN Retrospective, multicenter, observational study of oral mifepristone 200 mg and buccal misoprostol 800 mcg administered 24-48 h later for EMA (gestations ≤ 63 days). Odds ratios (ORs) [95% confidence intervals (CIs)] of EMA failure and continuing pregnancy for women with no defined IUGS vs. those with confirmed IUGS were calculated. RESULTS Women with no defined IUGS were more likely to experience EMA failure [9.0% (6/67) vs. 3.5% (465/13,345); OR (95% CI)=2.72 (1.17-6.33), p=.041] and continuing pregnancy [7.5% (5/67) vs. 0.6% (83/13,345); OR (95% CI)=12.72 (4.98-32.46), p<.001]. CONCLUSION EMA failure is more likely in women with early pregnancy and no defined IUGS than those with gestations ≤ 63 days and confirmed IUGS.
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Affiliation(s)
- Philip Goldstone
- Marie Stopes International Australia, PO Box 1635, Melbourne VIC 3001, Australia.
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Micks E, Shekell T, Stanley J, Zelinski M, Martin L, Riefenberg S, Adevai T, Jensen J. Medical termination of pregnancy in cynomolgus macaques. J Med Primatol 2012; 41:394-402. [PMID: 23078537 DOI: 10.1111/jmp.12019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although pregnancy is expected during studies of novel contraceptives in non-human primates, gestation, delivery, and lactation remove females from groups for prolonged intervals. As the macaque cervix does not facilitate transcervical surgical termination of pregnancy, we sought to establish a medical termination protocol. METHODS A descriptive case series of outcomes of medical termination of pregnancy up to 32 days gestation in cynomolgus monkeys. Efficacy and time to uterine resolution were determined according to medication, dose, and route of administration. RESULTS Thirty-seven macaques underwent 65 medical terminations. Over 80% of animals terminated after initial treatment with mifepristone 20 mg intramuscularly (IM). Intrafetal methotrexate was effective for salvage treatment. Medical termination regimens were less effective for animals receiving investigational contraceptive agents. CONCLUSIONS Medical termination for macaques is safe and effective. We recommend a protocol with mifepristone 20 mg IM and misoprostol 200 µg buccally as initial treatment.
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Affiliation(s)
- Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195-6460, USA.
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Boersma A, Alberts J, Bruijn JD, Meyboom BDJ, Kleiverda G. Termination of pregnancy in Curaçao: need for improvement of sexual and reproductive healthcare. Glob J Health Sci 2012; 4:30-8. [PMID: 22980230 PMCID: PMC4776944 DOI: 10.5539/gjhs.v4n3p30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 02/28/2012] [Indexed: 11/16/2022] Open
Abstract
Background: In Curaçao Termination of Pregnancy (TOP) is still forbidden by law, although a policy of tolerance has been stipulated since 1999. This paper is about the prevalence of TOP and about its health complications. These data on TOP are officially unknown but are suspected to be rather high. Methods: One year registration of illegal performed termination of pregnancy cases by all general physicians (GPs) practicing TOP in Curaçao. The registration included patient characteristics according to the model of the National Abortion Registration in The Netherlands, adjusted to the local Curaçao situation. Socio demographic characteristics, number of previous pregnancies and TOPs, pregnancy duration, contraception methods and reason for failure were registered. The comparative part of the research compares TOP rates of Curaçao with those of Antillean women in the Netherlands. The gynaecologists in the referral hospital registered complications requiring hospital admission after TOP. Results: All GPs performing TOP participated and the majority registered extensively. The total number of registered TOP was 1126. 666 of the 1126 were registered using the local adjusted Abortion Registration Model. With 30.000 women aged between 15 and 45 living in Curaçao, the TOP rate was at least 38 (per 1000 in that age category), comparable to rates for Antillean women in the Netherlands. Mean age was 26.9 years. Nearly half (47%) had one or more TOPs before; the majority (53%) was less than 7 weeks pregnant and two third (67%) had one or more children. Two third of the women did not use contraception (63%). For those using contraception, main reason for failure was inconsistent use (50%). There were 14 hospital admissions due to complications of TOP. Conclusion: The number of TOP is high in Curaçao and comparable to (first generation) Antillean women living abroad in the Netherlands. Most unintended pregnancies originated from no or inconsistent use of reliable contraception. Improvement of sex education is necessary in order to bring down the number of TOP, as well as realizing accessible and affordable contraception, including sterilization. The number of complications around TOPs was equal to other countries where TOP is illegal.
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Comparison of medical abortion follow-up with serum human chorionic gonadotropin testing and in-office assessment. Contraception 2012; 85:402-7. [DOI: 10.1016/j.contraception.2011.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 09/15/2011] [Accepted: 09/16/2011] [Indexed: 11/30/2022]
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Jackson AV, Dayananda I, Fortin JM, Fitzmaurice G, Goldberg AB. Can women accurately assess the outcome of medical abortion based on symptoms alone? Contraception 2012; 85:192-7. [DOI: 10.1016/j.contraception.2011.05.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 04/12/2011] [Accepted: 05/27/2011] [Indexed: 11/24/2022]
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Simmonds K, Likis FE. Caring for Women with Unintended Pregnancies. J Obstet Gynecol Neonatal Nurs 2011; 40:794-807. [DOI: 10.1111/j.1552-6909.2011.01293.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Kozma C, Ramasethu J. Methotrexate and misoprostol teratogenicity: Further expansion of the clinical manifestations. Am J Med Genet A 2011; 155A:1723-8. [DOI: 10.1002/ajmg.a.34037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 03/08/2011] [Indexed: 11/11/2022]
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Guo SW, Liu M, Shen F, Liu X. Use of mifepristone to treat endometriosis: a review of clinical trials and trial-like studies conducted in China. ACTA ACUST UNITED AC 2011; 7:51-70. [PMID: 21175391 DOI: 10.2217/whe.10.79] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
China was the first country in the world that approved mifepristone (RU-486) for abortion. A total of 6 years after the report published in the Western world indicated that mifepristone may also be effective in treating endometriosis, the first paper on the same topic was published in China in 1997. Since then, over 160 studies on this topic have been published in China. We retrieved 104 papers on clinical trials and trial-like studies conducted in China evaluating the use of mifepristone to treat endometriosis that were published in the last 11 years. We found that the quality of these studies is well below an acceptable level, making it difficult to judge whether mifepristone is truly efficacious. There are intriguing signs that these studies, as a whole, have serious anomalies. The areas that are glaringly deficient are informed consent, choice of outcome measures, the evaluation of outcome measures, data analysis and randomization. The uniformly low quality is disquieting, given the large quantity of studies, the enormous amount of resource and energy put into these studies and, above all, the weighty issue of treatment efficacy that concerns each and every patient with endometriosis. Equally disquieting are the low-quality repetition, the absence of a critical, systematic review on the subject, the lack of suggestions for multicenter clinical trials and the seemingly unnecessary duplication of clinical trials without due informed consent. In view of this, it may be time to institute changes in attitude and practice, and to change education and training programs in the methodology of clinical trials in obstetrics and gynecology research in China.
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Affiliation(s)
- Sun-Wei Guo
- Obstetrics & Gynecology Hospital, Fudan University Shanghai College of Medicine, 419 Fangxie Road, Shanghai 200011, China.
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de Costa CM. Use of mifepristone for medical abortion in Australia, 2006-2009. Med J Aust 2011; 194:206-7. [PMID: 21401466 DOI: 10.5694/j.1326-5377.2011.tb03778.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 11/29/2010] [Indexed: 11/17/2022]
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Boersma AA, Meyboom-de Jong B, Kleiverda G. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curaçao. EUR J CONTRACEP REPR 2011; 16:61-6. [DOI: 10.3109/13625187.2011.555568] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jackson E, Kapp N. Pain control in first-trimester and second-trimester medical termination of pregnancy: a systematic review. Contraception 2011; 83:116-26. [DOI: 10.1016/j.contraception.2010.07.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 06/29/2010] [Accepted: 07/14/2010] [Indexed: 11/27/2022]
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Jones RK. How commonly do US abortion patients report attempts to self-induce? Am J Obstet Gynecol 2011; 204:23.e1-4. [PMID: 20863478 DOI: 10.1016/j.ajog.2010.08.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 07/21/2010] [Accepted: 08/16/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study measures the extent to which women who access clinical abortion services in the United States report having ever used misoprostol or other substances to self-induce. STUDY DESIGN A random sample of 107 US abortion providers was asked to distribute questionnaires to abortion patients. RESULTS Information was gathered from 9493 patients at 95 facilities, and weights were constructed to make the data nationally representative of all US abortion patients. Only 1.2% of women obtaining abortions report having ever used misoprostol on their own to "bring back" their period or end a pregnancy. A similarly small proportion of women, 1.4%, reported using other substances, such as vitamin C or herbs, to attempt to end a pregnancy. CONCLUSION Media reports of self-induced abortions using misoprostol may be exaggerated, but further research is needed to estimate the incidence of self-induced abortion among women who do not access clinical abortion services.
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Spitz IM. Mifepristone: where do we come from and where are we going? Contraception 2010; 82:442-52. [DOI: 10.1016/j.contraception.2009.12.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Accepted: 12/15/2009] [Indexed: 01/08/2023]
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