Outpatient medical abortion is safe and effective through 70 days gestation

Abstract

Data show that an outpatient regimen of 200 mg mifepristone followed by a single dose of misoprostol is safe and effective for medical abortion for up to 70 days from last menstrual period (LMP). Yet, many clinics only provide services up to 63 days LMP, and some practice guidelines do not recommend the higher gestational age limit. We review the studies published to date that include women 64 to 70 days LMP and conclude that outpatient medical abortion is safe and effective in this interval, and that there are no clinically meaningful differences between outcomes at 57 to 63 days LMP and 64 to 70 days LMP. Updating clinical protocols and revising the FDA label for Mifeprex® to change the indication for termination of pregnancies through 70 days LMP will give women more choices and expand access to safe abortion services.

Comment: This paper rightly argues that medical abortion with the mifepristone/misoprostol combination is safe and effective up to at least 10 weeks of amenorrhea. There are even studies going on now to show good results up to 20 weeks, albeit with an extra dose of misoprostol. (HMV)