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Chapter 37 - Termination of Pregnancy

Medical Methods

from Section 2B - Sexual and Reproductive Healthcare: Termination of Pregnancy

Published online by Cambridge University Press:  16 January 2024

By
John J. Reynolds-Wright  and
Sharon T. Cameron
Edited by
Johannes Bitzer  and
Tahir A. Mahmood
Johannes Bitzer
Affiliation:
University Women's Hospital, Basel
Tahir A. Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
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Summary

Medical abortion is the use of medications, rather than surgical means to induce an abortion. The World Health Organization (WHO) recommends the use of a combination of mifepristone (a progesterone-receptor antagonist) followed by misoprostol (a synthetic prostaglandin) [1].

Type
Chapter
Information
Textbook of Contraception, Sexual and Reproductive Health , pp. 229 - 232
Publisher: Cambridge University Press
Print publication year: 2024

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References

World Health Organization. Medical management of abortion. Geneva: World Health Organization, 2018.Google Scholar
Baird, DT, Rodger, M, Cameron, IT, Roberts, I. Prostaglandins and antigestagens for the interruption of early pregnancy. J Reprod Fertil Suppl. 1988;36:173–9. www.ncbi.nlm.nih.gov/pubmed/3193407.Google ScholarPubMed
Akin, A, Dabash, R, Dilbaz, B et al. Increasing women’s choices in medical abortion: A study of misoprostol 400 microg swallowed immediately or held sublingually following 200 mg mifepristone. European Journal of Contraception and Reproductive Health Care: Official Journal of the European Society of Contraception. 2009;14(3):169–75. https://bit.ly/3Y4dRHh.CrossRefGoogle ScholarPubMed
Kapp, N, Eckersberger, E, Lavelanet, A, Rodriguez, MI. Medical abortion in the late first trimester: A systematic review. Contraception. 2019;99(2):77–86. www.ncbi.nlm.nih.gov/pubmed/30444970.CrossRefGoogle ScholarPubMed
Raymond, EG, Shannon, C, Weaver, MA, Winikoff, B. First-trimester medical abortion with mifepristone 200 mg and misoprostol: A systematic review. Contraception. 2013;87(1):26–37. www.sciencedirect.com/science/article/pii/S0010782412006439.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Abortion care. NG140 edition. London: National Institute for Health and Care Excellence, 2019. www.nice.org.uk/guidance/NG140.Google Scholar
Cameron, ST, Glasier, A, Dewart, H, Johnstone, A, Burnside, A. Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: A service evaluation. Contraception. 2012;86(1):67–73. https://bit.ly/3HVuH5w.CrossRefGoogle ScholarPubMed
Reeves, MF, Fox, MC, Lohr, PA, Creinin, MD. Endometrial thickness following medical abortion is not predictive of subsequent surgical intervention. Ultrasound in Obstetrics and Gynecology. 2009;34(1):104–9. https://doi.org/10.1002/uog.6404.CrossRefGoogle Scholar
Ngoc, NTN, Shochet, T, Raghavan, S et al. Mifepristone and misoprostol compared with misoprostol alone for second-trimester abortion: A randomized controlled trial. Obstetrics and Gynecology. 2011;118(3):601–8. https://bit.ly/3jvGIW8.CrossRefGoogle ScholarPubMed
Royal College of Obstetricians and Gynaecologists. The care of women requesting induced abortion: Evidence-based clinical guideline number 7. London: Royal College of Obstetricians and Gynaecologists, 2011. http://bit.ly/3l9NnWr.Google Scholar
Avraham, S, Gat, I, Duvdevani, N-R et al. Pre-emptive effect of ibuprofen versus placebo on pain relief and success rates of medical abortion: A double-blind, randomized, controlled study. Fertility and Sterility. 2012;97(3):612–15. https://bit.ly/3HTInhC.CrossRefGoogle ScholarPubMed
Livshits, A, Machtinger, R, David, LB et al. Ibuprofen and paracetamol for pain relief during medical abortion: A double-blind randomized controlled study. Fertility and Sterility. 2009;91(5):1877–80. https://bit.ly/3wWhSla.CrossRefGoogle ScholarPubMed
Fiala, C, Swahn, ML, Stephansson, O, Gemzell-Danielsson, K. The effect of non-steroidal anti-inflammatory drugs on medical abortion with mifepristone and misoprostol at 13–22 weeks gestation. Hum Reprod. 2005;20(11):3072–7. www.ncbi.nlm.nih.gov/pubmed/16055455.CrossRefGoogle ScholarPubMed
Jackson, E, Kapp, N. Pain control in first-trimester and second-trimester medical termination of pregnancy: A systematic review. Contraception. 2011;83(2):116–26. https://bit.ly/3wUEnHe.CrossRefGoogle ScholarPubMed

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