Management of very early medical abortion—An international survey among providers

Fiala, Christian; Bombas, Teresa; Parachini, Mirella; Agostini, Aubert; Lertxundi, Roberto; Ľubušký, Marek; Saya, Laurence; Danielsson, Kristina Gemzell

doi:10.1016/j.ejogrb.2020.01.022

Cited by 4 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 A survey among international abortion providers showed that women frequently seek abortion at very early gestation, and that there has been an increase in these requests over recent years. 7 However, the same study showed inconsistency in clinical practice regarding provision of VEMA or delaying abortion until IUP is confirmed. 7 Providers may decide to delay the abortion until an IUP can be visualized using ultrasound.…”

Section: Introductionmentioning

confidence: 93%

“…7 However, the same study showed inconsistency in clinical practice regarding provision of VEMA or delaying abortion until IUP is confirmed. 7 Providers may decide to delay the abortion until an IUP can be visualized using ultrasound. This may be due to concerns about efficacy at very early gestations, clinical guidance or legislation mandating confirmation of IUP, or concerns about "missing" an undiagnosed ectopic pregnancy.…”

Section: Introductionmentioning

confidence: 93%

“…Out of these, three articles were conference abstracts and one article was a survey on clinicians' experience of VEMA and did not include any data on our outcomes of interest. 7 The six included articles (two reporting on the same cohort) are presented in ►Table 1. The included studies were generally of limited quality due to observational design and/or small sample size.…”

Section: Included Studiesmentioning

confidence: 99%

“…[2][3][4][5][6] The term "very early medical abortion" (VEMA) has recently been used to describe medical abortion before intrauterine pregnancy (IUP) is visualized on ultrasound scan (USS). 7,8 The first definitive sign of an IUP on ultrasound is the presence of a yolk sac. An empty cavity (often referred to as a pregnancy of unknown location or PUL) or an intrauterine sac-like structure (probable IUP) on ultrasound are classified as nonconfirmed IUP.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Medical Abortion before Confirmed Intrauterine Pregnancy: A Systematic Review

et al. 2022

View full text Add to dashboard Cite

Abstract“Very early medical abortion” (VEMA) refers to medical abortion (with mifepristone and misoprostol) before intrauterine pregnancy is visualized on ultrasound. Our aim is to present the current evidence on efficacy, safety (focused on ectopic pregnancies), and how to assess treatment success of VEMA. We conducted a systematic review of studies reporting outcomes of VEMA. The field is small and so our objective was to map all relevant literature, without conducting meta-analysis. We searched PubMed, Medline, and Embase on April 19, 2022. We conducted a narrative synthesis of the evidence. A total of 373 articles were identified. Six articles (representing four observational and one pilot trial) were included in the final review. Across all included studies, treatment efficacy ranged between 91 and 100%. Prevalence of ectopic pregnancy was low and very few cases (n = 2) of ruptures were reported. Most studies used serial serum human chorionic gonadotrophin (s-hCG) levels to determine success of abortion; one study used low sensitivity urine hCG. From the available evidence, VEMA appears to be efficacious and does not appear to cause harm to ectopic pregnancies. Treatment can be assessed with pre- and postabortion s-hCG. Good quality, randomized controlled trial evidence is needed to best inform practice.

show abstract

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 93%

Section: Included Studiesmentioning

confidence: 99%