Literature DB >> 23262942

Significant adverse events and outcomes after medical abortion.

Kelly Cleland1, Mitchell D Creinin, Deborah Nucatola, Montsine Nshom, James Trussell.   

Abstract

OBJECTIVE: To analyze rates of significant adverse events and outcomes in women having a medical abortion at Planned Parenthood health centers in 2009 and 2010 and to identify changes in the rates of adverse events and outcomes between the 2 years.
METHODS: In this database review we analyzed data from Planned Parenthood affiliates that provided medical abortion in 2009 and 2010 almost exclusively using an evidence-based buccal misoprostol regimen. We evaluated the incidence of six clinically significant adverse events (hospital admission, blood transfusion, emergency department treatment, intravenous antibiotics administration, infection, and death) and two significant outcomes (ongoing pregnancy and ectopic pregnancy diagnosed after medical abortion treatment was initiated). We calculated an overall rate as well as rates for each event and identified changes between the 2 years.
RESULTS: Among 233,805 medical abortions provided in 2009 and 2010, significant adverse events or outcomes were reported in 1,530 cases (0.65%). There was no statistically significant difference in overall rates between years. The most common significant outcome was ongoing intrauterine pregnancy (0.50%); significant adverse events occurred in 0.16% of cases. One patient death occurred as a result of an undiagnosed ectopic pregnancy. Only rates for emergency department treatment and blood transfusion differed by year and were slightly higher in 2010.
CONCLUSION: Review of this large data set reinforces the safety of the evidence-based medical abortion regimen. LEVEL OF EVIDENCE: III.

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Year:  2013        PMID: 23262942      PMCID: PMC3711556          DOI: 10.1097/aog.0b013e3182755763

Source DB:  PubMed          Journal:  Obstet Gynecol        ISSN: 0029-7844            Impact factor:   7.661


  12 in total

1.  Abortion, pregnancy, and public health.

Authors:  Mitchell D Creinin
Journal:  Obstet Gynecol       Date:  2012-02       Impact factor: 7.661

2.  Pregnancy-related mortality in the United States, 1998 to 2005.

Authors:  Cynthia J Berg; William M Callaghan; Carla Syverson; Zsakeba Henderson
Journal:  Obstet Gynecol       Date:  2010-12       Impact factor: 7.661

3.  Two distinct oral routes of misoprostol in mifepristone medical abortion: a randomized controlled trial.

Authors:  Beverly Winikoff; Ilana G Dzuba; Mitchell D Creinin; William A Crowden; Alisa B Goldberg; Juliana Gonzales; Michelle Howe; Jeffrey Moskowitz; Linda Prine; Caitlin S Shannon
Journal:  Obstet Gynecol       Date:  2008-12       Impact factor: 7.661

4.  Early pregnancy termination with mifepristone and misoprostol in the United States.

Authors:  I M Spitz; C W Bardin; L Benton; A Robbins
Journal:  N Engl J Med       Date:  1998-04-30       Impact factor: 91.245

5.  Epidemiological assessment of misoprostol teratogenicity.

Authors:  I M Orioli; E E Castilla
Journal:  BJOG       Date:  2000-04       Impact factor: 6.531

6.  Safety of mifepristone abortions in clinical use.

Authors:  Jillian T Henderson; Ann C Hwang; Cynthia C Harper; Felicia H Stewart
Journal:  Contraception       Date:  2005-09       Impact factor: 3.375

7.  Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days.

Authors:  Mary Fjerstad; Irving Sivin; E Steve Lichtenberg; James Trussell; Kelly Cleland; Vanessa Cullins
Journal:  Contraception       Date:  2009-05-02       Impact factor: 3.375

Review 8.  Medication abortion.

Authors:  Deborah Bartz; Alisa Goldberg
Journal:  Clin Obstet Gynecol       Date:  2009-06       Impact factor: 2.190

9.  Rates of serious infection after changes in regimens for medical abortion.

Authors:  Mary Fjerstad; James Trussell; Irving Sivin; E Steve Lichtenberg; Vanessa Cullins
Journal:  N Engl J Med       Date:  2009-07-09       Impact factor: 91.245

10.  Misoprostol and congenital anomalies.

Authors:  R Brasil; H Lutéscia Coelho; B D'Avanzo; C La Vecchia
Journal:  Pharmacoepidemiol Drug Saf       Date:  2000-09       Impact factor: 2.890

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  20 in total

1.  Reduction in infection-related mortality since modifications in the regimen of medical abortion.

Authors:  James Trussell; Deborah Nucatola; Mary Fjerstad; E Steve Lichtenberg
Journal:  Contraception       Date:  2013-12-11       Impact factor: 3.375

2.  State Law Approaches to Facility Regulation of Abortion and Other Office Interventions.

Authors:  Bonnie S Jones; Sara Daniel; Lindsay K Cloud
Journal:  Am J Public Health       Date:  2018-02-22       Impact factor: 9.308

3.  Telemedicine and medical abortion: dispelling safety myths, with facts.

Authors:  Roopan Gill; Wendy V Norman
Journal:  Mhealth       Date:  2018-02-01

4.  Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days.

Authors:  Mary Gatter; Kelly Cleland; Deborah L Nucatola
Journal:  Contraception       Date:  2015-01-13       Impact factor: 3.375

5.  Safety and effectiveness of self-managed medication abortion provided using online telemedicine in the United States: A population based study.

Authors:  Abigail R A Aiken; Evdokia P Romanova; Julia R Morber; Rebecca Gomperts
Journal:  Lancet Reg Health Am       Date:  2022-02-17

6.  The public health threat of anti-abortion legislation.

Authors:  Daniel Grossman; Kari White; Kristine Hopkins; Joseph E Potter
Journal:  Contraception       Date:  2013-11-04       Impact factor: 3.375

Review 7.  Medication to Manage Abortion and Miscarriage.

Authors:  Jessica Beaman; Christine Prifti; Eleanor Bimla Schwarz; Mindy Sobota
Journal:  J Gen Intern Med       Date:  2020-05-14       Impact factor: 5.128

8.  Abortion legislation, maternal healthcare, fertility, female literacy, sanitation, violence against women and maternal deaths: a natural experiment in 32 Mexican states.

Authors:  Elard Koch; Monique Chireau; Fernando Pliego; Joseph Stanford; Sebastian Haddad; Byron Calhoun; Paula Aracena; Miguel Bravo; Sebastián Gatica; John Thorp
Journal:  BMJ Open       Date:  2015-02-23       Impact factor: 2.692

9.  Off-label use of misoprostol in gynaecology.

Authors:  J V Turner; S Agatonovic-Kustrn; Hrg Ward
Journal:  Facts Views Vis Obgyn       Date:  2015-12-28

Review 10.  Effectiveness, safety, and acceptability of first-trimester medical termination of pregnancy performed by non-doctor providers: a systematic review.

Authors:  S Sjöström; M Dragoman; M S Fønhus; B Ganatra; K Gemzell-Danielsson
Journal:  BJOG       Date:  2017-08-17       Impact factor: 6.531

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