Efficacy and acceptability of early mifepristone-misoprostol medical abortion in Ukraine: Results of two clinical trials

Raghavan, Sheila; Maistruk, Galina; Shochet, Tara; Bannikov, Vladimir I.; Posohova, Svetlana; Zhuk, S. Ya.; Lishchuk, Vladimir; Winikoff, Beverly

doi:10.3109/13625187.2013.769951

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Thus, these variables partly explain the same variation, and the adjusted OR estimate for home use of medical abortion medication (independently of the other variables) is reversed. However, home use is safe and effective, showing that health professionals are no longer obliged to directly dispense the medication to patients 12 , 24 , 28 – 30 . Clinicians can prescribe mifepristone, misoprostol, and pain medications for home use, which may enhance patient experience and increase satisfaction and privacy, the latter of which is pivotal in abortion care.…”

Section: Discussionmentioning

confidence: 99%

First trimester abortion protocols by facility type in Switzerland and potential barriers to accessing the service

Eckstein

Felten

Perotto

et al. 2023

Sci Rep

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Simplified first-trimester abortion protocols are well established. However, data on the use of medical or surgical abortion protocols across Switzerland is lacking. We report protocol characteristics in abortion care for two different facility types, hospital vs private practices (office-based) in Switzerland. Furthermore, we investigate an association between protocol characteristics and the likelihood of following through with the abortion at the same facility. We also report abortion outcomes of an office-based cohort where doctors use simplified abortion protocols. This study consists of two parts. (i) Between April and July, 2019, we collected data regarding medical and surgical abortion protocols of institutions offering abortions, in a nationwide survey. We assessed whether the proportion of patients who followed through with the abortion (primary outcome) after first appointment was associated with predefined protocol characteristics, considered to complicate access to abortion services, using generalised estimating equations. (ii) We analysed abortion outcomes of six selected office-based facilities from January, 2008, to December, 2018, using simplified abortion protocols in accordance with the Worlds Health Organisation (WHO) guidelines. (i) We included a total of 39 institutions. Hospitals showed more protocol-based barriers to abortion access compared with office-based facilities. The odds of undergoing an abortion after the first appointment were increased using protocols with minimal barriers. Overall, office-based facilities applied higher gestational age limits, required fewer appointments, and administered mifepristone more often after the first visit than did hospitals. (ii) We included a total of 5274 patients with an incidence of complications requiring surgery of 2.5% in line with rates reported in published literature. Only a few hospitals provide abortion care with easy access to medical and surgical abortion, whereas most office-based facilities do. Access to abortion services is generally crucial, and should be provided in a single visit whenever clinically permissible.

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Section: Discussionmentioning

confidence: 99%

First trimester abortion protocols by facility type in Switzerland and potential barriers to accessing the service

Eckstein

Felten

Perotto

et al. 2023

Sci Rep

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“…В анализа са включени само разходи за овладяване на НЛР от гледна точка на платеца (НЗОК). По литературни данни ефикасността на медикаментозния аборт е по-висока при прекъсване на бременността в първия триместър (до 98%), отколкото във втория триместър (около 94%) [22,23].…”

Section: разходи за контрол на нежелани лекарствени реакции (нлр)unclassified

Pharmacoeconomic analysis of medical abortion in Bulgaria

Grigorov

Belcheva

et al. 2020

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Mедикаментозният метод за прекъсване на ранна бременност започва с идентифицирането на простагландините. През 70-те години много от развитите държави легализират аборта, което води и до развитието и активното прилагане на тази здравна технология в световен мащаб. Във фармакоикономическия анализ е използван методът разход-минимум, като се сравняват разходите по прекъсване на бременност на два от най-популярните протокола и режима на дозировка с наличните към момента на проучването на българския пазар лекарствени продукти и разходите при класически аборт. Отчетени са и вероятностите за евентуални усложнения. При еквивалентна ефикасност на двете процедури, прилагането на анализ от типа разход-минимум (CMA) е подходящ и логичен избор. Проведеният анализ установява, че медикаментозното прекъсване на бременността по протокола на Европейска лекарствена агенция (ЕМА) (Mifepristone 600mg + Misoprostol 400mcg) е с малко по-висок разход за пациент в сравнение с хирургичния аборт, ако процедурата се извършва през първия триместър на бременността (∆Разходи=+10,61лв.) и води до спестен разход за пациент по време на втория триместър на бременността (∆Разходи=-90,96лв.). Медикаментозното прекъсване на бременността по протокола на СЗО води до спестен разход на пациент в сравнение с хирургичния аборт, независимо от периода на бременността, в който се извършва процедурата (∆Разходи =-50,43лв в първи триместър и ∆Разходи =-156,60 във втория триместър). Медикаментозното прекъсване на бременността е неинвазивно, високо ефективно и безопасно, наподобявайки естествения механизъм на спонтанния аборт, като в повечето случаи води до спестяване на разходи и може да се разглежда като реална алтернатива на класическия хирургичен аборт.

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Provision of medical abortion using telemedicine in Brazil

Gomperts¹,

Vleuten²,

Jelinska³

et al. 2014

Contraception

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Efficacy and acceptability of early mifepristone-misoprostol medical abortion in Ukraine: Results of two clinical trials

Abstract: The two studies demonstrate high rates of success and acceptability of early medical abortion in Ukraine.

Cited by 5 publications

References 16 publications

First trimester abortion protocols by facility type in Switzerland and potential barriers to accessing the service

First trimester abortion protocols by facility type in Switzerland and potential barriers to accessing the service

Pharmacoeconomic analysis of medical abortion in Bulgaria

Provision of medical abortion using telemedicine in Brazil

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