Acceptability and feasibility of the use of 400 μg of sublingual misoprostol after mifepristone for medical abortion up to 63 days since the last menstrual period: Evidence from Uzbekistan

Raghavan, Sheila; Tsereteli, Tamar; Kamilov, A.; Kurbanbekova, Dilfuza; Yusupov, Dilmurod; Kasimova, Feruza; Jymagylova, Dilbar; Winikoff, Beverly

doi:10.3109/13625187.2013.763225

Cited by 14 publications

(7 citation statements)

References 26 publications

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“…Our baseline assumptions for sample size included an ongoing pregnancy rate of 1.2% based on previous studies [16,17]; however, the ongoing pregnancy rate in this study was lower among women assigned to both phone and clinic follow-up, and this fact may have reduced our statistical power to detect any differences. In addition, our study did not require all women to return to the clinic to verify their abortion outcome.…”

Section: Discussionmentioning

confidence: 96%

“…We estimated (with α= 0.05, 1-β=0.8, with a one-tailed test) that at least 14 ongoing pregnancies should occur per group. Based on previous data from these facilities, we estimated that ongoing pregnancy would occur in about 1.2% cases of medical abortion [16,17]; therefore, we would be required to enroll approximately 1167 women in each group. Finally, to account for loss to follow-up, we rounded up to 1200 women in each group, with a total sample size of 2400 women.…”

Section: Methodsmentioning

confidence: 99%

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Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

et al. 2015

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

et al. 2015

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“…The woman should understand how much bleeding is considered too much. Women can safely and effectively self-administer misoprostol at home as part of a medical abortion regimen (32,34,35). Buccal and sublingual misoprostol can be administered as early as 24 hours after mifepristone administration (32,33).…”

Section: Adverse Effectsmentioning

confidence: 99%

Practice Bulletin No. 143

2014

Obstetrics &Amp; Gynecology

107

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Over the past three decades, medical methods of abortion have been developed throughout the world and are now a standard method of providing abortion care in the United States. Medical abortion, which involves the use of medications rather than a surgical procedure to induce an abortion, is an option for women who wish to terminate a first-trimester pregnancy. Although the method is most commonly used up to 63 days of gestation (calculated from the first day of the last menstrual period), the treatment also is effective after 63 days of gestation. The Centers for Disease Control and Prevention estimates that 64% of abortions are performed before 63 days of gestation (1). Medical abortions currently comprise 16.5% of all abortions in the United States and 25.2% of all abortions at or before 9 weeks of gestation (1). Mifepristone, combined with misoprostol, is the most commonly used medical abortion regimen in the United States and Western Europe; however, in parts of the world, mifepristone remains unavailable. This document presents evidence of the effectiveness, benefits, and risks of first-trimester medical abortion and provides a framework for counseling women who are considering medical abortion.

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“…Extensive evidence regarding both efficacy and acceptability supports the outpatient use of medical abortion through 63 days since the last menstrual period (LMP). [1][2][3][4][5][6] In this pregnancy range, among the World Health Organization's (WHO) recommended regimens is 200 mg mifepristone followed by 800 μg buccal misoprostol; 7 this protocol is routinely used for legal abortion in the outpatient facilities of the Secretariat of Health of Mexico City (SSDF), 6,8 where approximately 71% of women who obtain services have a medical abortion. 9 In Mexico, abortion is legal in the first trimester of pregnancy, and the first mifepristone product was registered there in 2011.…”

mentioning

confidence: 99%

Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City

Smith¹,

Peña

Dzuba³

et al. 2014

Reproductive Health Matters

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Extensive evidence exists regarding the efficacy and acceptability of medical abortion through 63 days since last menstrual period (LMP). In Mexico City's Secretariat of Health (SSDF) outpatient facilities, mifepristone-misoprostol medical abortion is the first-line approach for abortion care in this pregnancy range. Recent research demonstrates continued high rates of complete abortion through 70 days LMP. To expand access to legal abortion services in Mexico City (where abortion is legal through 12 weeks LMP), this study sought to assess the efficacy and acceptability of the standard outpatient approach through 70 days in two SSDF points of service. One thousand and one women seeking pregnancy termination were enrolled and given 200 mg mifepristone followed by 800 μg misoprostol 24-48 hours later. Women were asked to return to the clinic one week later for evaluation. The great majority of women (93.3%; 95% CI: 91.6-94.8) had complete abortions. Women with pregnancies ≤ 8 weeks LMP had significantly higher success rates than women in the 9th or 10th weeks (94.9% vs. 90.5%; p = 0.01). The difference in success rates between the 9th and 10th weeks was not significant (90.0% vs. 91.2%; p = 0.71). The majority of women found the side effects (82.9%) and the use of misoprostol (84.4%) to be very acceptable or acceptable. This study provides additional evidence supporting an extended outpatient medical abortion regimen through 10 weeks LMP.

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Acceptability and feasibility of the use of 400 μg of sublingual misoprostol after mifepristone for medical abortion up to 63 days since the last menstrual period: Evidence from Uzbekistan

Abstract: Mifepristone medical abortion with home administration of misoprostol is an acceptable and feasible option for women in Uzbekistan. The method worked well at all three facility types.

Cited by 14 publications

References 26 publications

Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

Practice Bulletin No. 143

Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City

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