Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curaçao

Abstract

Home administration of buccal misoprostol 24-36 h after mifepristone is a safe and effective method of medical abortion up to 70 days. It could be applied in a general practice in Curaçao, where induced abortion is legally restricted.

Mifepristone With Buccal Misoprostol for Medical Abortion

“…13 The overall efficacy and continuing pregnancy rate after mifepristone followed by buccal misoprostol is 96.6% and 0.8%, respectively, through 70 days of gestation in the 33,846 women who were included in this systematic review (Table 1). However, only 332 women are reported in the literature between 64 and 70 days of gestation from three trials [14][15][16] with 304 of the patients from a single trial. 14 The overall efficacy at 64-70 days of gestation is 93.1%.…”

“…However, only 332 women are reported in the literature between 64 and 70 days of gestation from three trials [14][15][16] with 304 of the patients from a single trial. 14 The overall efficacy at 64-70 days of gestation is 93.1%. Ongoing pregnancy rate at 64-70 days of gestation (n5306) Unauthorized reproduction of this article is prohibited.…”

“…14,22,23 Outcomes by gestational age were reported for 12,050, 4,032, and 2,153 women with pregnancies 49 days or less, 50-56 days, and 57-63 days of gestation, respectively. All studies used 800 micrograms misoprostol buccally 11,[14][15][16][22][23][24][25][26][27][28][29][30] except for one study that reported clinical outcomes with 400 micrograms misoprostol buccally. 31 One study described the actual time interval at which patients administered misoprostol after mifepristone, reporting a median interval of 48 hours (range 25-52 hours) for women who took mifepristone at home and a median interval of 47 hours (range 26-54 hours) for women that took mifepristone in the clinic.…”

Trends in use of medical abortion in the United States: reanalysis of surveillance data from the Centers for Disease Control and Prevention, 2001–2008

“…The dramatic decrease in medical abortion after 8 weeks' gestation that has been documented in CDC data [4] suggests that this gestational age cutoff is appropriate for the purpose of surveillance. However, given research showing continuing efficacy of mifepristone and misoprostol between 9 and 13 weeks' gestation [28][29][30][31][32][33], this cutoff will need to be reconsidered upon any indication of changes in abortion practice patterns in the United States. CDC will continue to monitor patterns in reported use of medical abortion by gestational age and adjust its classification of abortions as necessary.…”

Adolescent Girls and Abortion

“…[13][14][15] Several studies support the use of medication abortion up to 10 weeks gestation. [16][17][18][19] Some reasons patients may prefer medical abortion include a sense of "privacy" associated with having the abortion at home, shorter clinical visits, and no requirement of a surgical procedure or anesthesia. This method allows patients to control the timing of their abortion by choosing when to take their misoprostol.…”