Medical abortion

Medical abortion
Background
Abortion typeMedical
First useUnited States 1979 (carboprost),
West Germany 1981 (sulprostone),
Japan 1984 (gemeprost),
France 1988 (mifepristone),
United States 1988 (misoprostol)
Gestation3–24+ weeks
Usage
Medical abortions as a percentage of all abortions
France76% (2021)
Sweden96% (2021)
UK: Eng. & Wales87% (2021)
UK: Scotland99% (2021)
United States63% (2023)
Infobox references
Mifepristone/misoprostol
Combination of
MifepristoneProgesterone receptor modulator
MisoprostolProstaglandin
Clinical data
Trade namesMifegymiso,[1] others
Routes of
administration
Buccal, by mouth
ATC code
Legal status
Legal status

A medical abortion, also known as medication abortion or non-surgical abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage.[6] Medical abortions are more common than surgical abortions in most places around the world.[7][8]

Medical abortions are most commonly performed by administering a two-drug combination: mifepristone followed by misoprostol. Evidence suggests this two-drug combination is the most effective at producing a complete abortion up to 65 days after menstrual bleeding has stopped.[6] When mifepristone is not available, misoprostol alone may be used in some situations.[9]

Medical abortion is both safe and effective throughout a range of gestational ages, including the second and third trimester.[10][11][12] In the United States, the mortality rate for medical abortion is 14 times lower than the mortality rate for childbirth, and the rate of serious complications requiring hospitalization or blood transfusion is less than 0.4%.[13][14][15][16] Medical abortion can be administered safely by the patient at home, without assistance, in the first trimester.[17] In the second trimester and beyond, it is recommended to take the second drug in a clinic, provider's office, or other supervised medical facility.[17]

  1. ^ a b Linepharma International Limited (April 15, 2019). "Mifegymiso Product Monograph" (PDF). Health Canada.
  2. ^ "AusPAR: MS-2 Step (composite pack)". Therapeutic Goods Administration (TGA). February 15, 2024. Retrieved March 31, 2024.
  3. ^ "Health Canada New Drug Authorizations: 2015 Highlights". Health Canada. May 4, 2016. Retrieved April 7, 2024.
  4. ^ "Medabon - Combipack of Mifepristone 200 mg tablet and Misoprostol 4 x 0.2 mg vaginal tablets - Summary of Product Characteristics (SmPC)". Electronic Medicines Compendium (EMC). February 3, 2020. Retrieved January 19, 2021.
  5. ^ "Mifepristone/misoprostol: List of nationally authorised medicinal products" (PDF). European Medicines Agency. January 14, 2021. PSUSA/00010378/202005.
  6. ^ a b Zhang J, Zhou K, Shan D, Luo X (May 2022). "Medical methods for first trimester abortion". The Cochrane Database of Systematic Reviews. 2022 (5): CD002855. doi:10.1002/14651858.CD002855.pub5. PMC 9128719. PMID 35608608.
  7. ^ Cite error: The named reference Kapp 2009 was invoked but never defined (see the help page).
  8. ^ Jones RK (December 1, 2022). "Medication Abortion Now Accounts for More Than Half of All US Abortions". Guttmacher Institute. Retrieved April 16, 2023.
  9. ^ Langer BR, Peter C, Firtion C, David E, Haberstich R (2004). "Second and third medical termination of pregnancy with misoprostol without mifepristone". Fetal Diagnosis and Therapy. 19 (3): 266–270. doi:10.1159/000076709. PMID 15067238. S2CID 25706987.
  10. ^ Vlad S, Boucoiran I, St-Pierre ÉR, Ferreira E (June 2022). "Mifepristone-Misoprostol Use for Second- and Third-Trimester Medical Termination of Pregnancy in a Canadian Tertiary Care Centre". Journal of Obstetrics and Gynaecology Canada. 44 (6): 683–689. doi:10.1016/j.jogc.2021.12.010. PMID 35114381. S2CID 246505706.
  11. ^ Whitehouse K, Brant A, Fonhus MS, Lavelanet A, Ganatra B (2020). "Medical regimens for abortion at 12 weeks and above: a systematic review and meta-analysis". Contraception. 2: 100037. doi:10.1016/j.conx.2020.100037. PMC 7484538. PMID 32954250.
  12. ^ Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. (Cochrane Editorial Unit) (October 2019). "Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions". The Cochrane Database of Systematic Reviews. 10 (10): ED000142. doi:10.1002/14651858.ED000142. PMC 10284251. PMID 31643080.
  13. ^ Cite error: The named reference ANSIRH_2019-04 was invoked but never defined (see the help page).
  14. ^ Cite error: The named reference FDA_2018-12-31 was invoked but never defined (see the help page).
  15. ^ Cite error: The named reference C_2012-06-19 was invoked but never defined (see the help page).
  16. ^ Cite error: The named reference NYT_2022-08-07 was invoked but never defined (see the help page).
  17. ^ a b Cite error: The named reference WHO362 was invoked but never defined (see the help page).

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