Misoprostol safe alternative to mifepristone for first-trimester medication abortion
Medical abortion is a procedure in which prescription drugs are used to terminate pregnancy without resorting to any surgical procedure. Usually it is performed through the ninth week of pregnancy and involves taking two medications — mifepristone and misoprostol. Mifepristone works by blocking the hormone progesterone without which the pregnancy cannot continue to grow in the uterus. However Misoprostol causes cramping and bleeding to empty the uterus.
Dr Elizabeth G. Raymond and associates have found in a new study that Misoprostol-only is an effective and safe option for terminating a first trimester intrauterine pregnancy when mifepristone is unavailable or inaccessible, according to there recent study results.
The study's main objective was to update the 2019 systematic data review on the effectiveness and safety of misoprostol-only for first-trimester abortion.
The team searched PubMed and found articles describing outcomes of treatment with misoprostol-only for abortion of viable intrauterine pregnancy at ≤91 days of gestation. They assessed bias risk using four defined indicators.
They estimated treatment failure proportions using meta-analytic methods and the proportion of hospitalized or transfused after treatment.
The team examined associations between treatment failure and selected characteristics of the groups.
The key results of the study are:
- They identified 49 papers with 66 groups, including 16,354 evaluable patients.
- Two thousand nine hundred sixty patients had treatment failures.
- Out of 9,228 patients assessed, 521 had that condition.
- There was an association of the Failure risk with misoprostol dose, the total allowed number of doses, the maximum dosing duration and indicators of bias risk.
- Among 11,007 patients allowed to take at least three misoprostol doses, the first consisting of misoprostol 800 mcg administered vaginally, sublingually, or buccally, the meta-analytic estimate of the failure risk was 11%.
- 0.2% of 15,679 evaluable patients were hospitalized or received transfusions.
Concluding further, they said the results continue to support the key conclusion of our 2019 analysis.
According to researchers Misoprostol-only is effective and safe for first trimester intrauterine pregnancy termination, if mifepristone is unavailable or inaccessible.
Further reading:
https://www.contraceptionjournal.org/article/S0010-7824(23)00226-3/fulltext
