Int J Gynaecol Obstet. 2016 May 26. pii:

Prospective study of home use of mifepristone and misoprostol for medical abortion up to 10 weeks of pregnancy in Kazakhstan

Platais I, Tsereteli T, Grebennikova G, Lotarevich T and Winikoff B

Abstract

Objective: To evaluate the efficacy of at-home medical abortion in Kazakhstan.

Methods: A comparative, non-randomized study was undertaken at three clinics in Kazakhstan between October 10, 2013, and November 27, 2014. Women who sought medical abortion and had an intrauterine pregnancy of up to 70 days were enrolled. All participants took 200 mg mifepristone followed by 600μg sublingual misoprostol 24-48 hours later. Women were offered the choice to take mifepristone at the clinic or at home; all took misoprostol at home. Abortion completion was assessed at an in-clinic follow-up appointment scheduled for all participants 2 weeks after mifepristone administration.

Results: Of 290 enrolled women, 185 (63.8%) chose to self-administer mifepristone at home. Three (1.0%) of 289 women included in outcome analyses required surgical intervention for incomplete abortion. Therefore, the overall success rate was 99.0% (95% confidence interval 97.0%-99.7%). No serious adverse events occurred.

Conclusion: Outpatient medical abortion with mifepristone and misoprostol is safe and effective up to 70 days of pregnancy. This service should be offered to women in Kazakhstan.

Comment: The previous abstract mentioned safe medical abortion by nurse/midwives and this paper describes the successful and safe use of a mifepristone/misoprostol combination during home use. This is not only relevant for Kazakhstan, but also everywhere. (HMV)