Medical Abortion Research Articles

Screening of key active ingredients of Fuyuan Shenghua granules for the treatment of medical abortion using ingredient-target interaction and pharmacokinetics.

Fuyuan Shenghua granule (FYSHG) is a clinical herbal formula adapted for medical abortion as an adjuvant treatment. This study aimed to screen the key active ingredients of FYSHG in treating medical abortion in vivo using ingredient-protein interaction and pharmacokinetics. The main ingredients of FYSHG absorbed in the blood were identified through UHPLC-Q-TOF/MS. An ingredient-target interaction network was constructed and analyzed to screen the key active ingredients of FYSHG in the treatment of medical abortion. The network was validated via molecular docking in silico and surface plasmon resonance (SPR) assays in vitro. Finally, the concentration was analyzed via UHPLC‒MS/MS, and pharmacokinetic characteristics including AUC, Cmax, MRT, T1/2 were calculated for further evaluation. In total, 34 active ingredients of FYSHG absorbedintheblood were identified via UHPLC-Q-TOF/MS. Among them, 6-gingerol (0.008mg/g), 6-shogaol (0.012mg/g), amygdalin (1.677mg/g), astragaloside IV (0.022mg/g), calycosin-7-glucoside (0.25mg/g), and senkyunolide H (0.066mg/g) were identified as the six key active ingredients of FYSHG. The Cmax values of these ingredients ranged from 42 to 288µg/L, with t1/2 values ranging from 4.3 to 12.13h, suggesting fast absorption, no obvious accumulation, and good drug-like properties. This study revealed that 6-gingerol, 6-shogaol, amygdalin, astragaloside IV, calycosin-7-glucoside, and senkyunolide H were six key active ingredients of FYSHG in vivo. These findings might contribute to the treatment of medical abortion.

Innovation through telemedicine to improve medication abortion access in primary health centers: findings from a pilot study in Musanze District, Rwanda

In 2012 Rwanda expanded legal grounds for abortion to include cases of rape, incest, forced marriage, the health of a pregnant person or fetus at risk, and for minors on request in 2018. The penal code limits abortion care to doctors in hospitals, impeding access for many women. We tested an intervention that provides first-trimester medication abortion at primary health centers, using telemedicine to connect nurses/midwives to doctors in district hospitals for authorization of services. We implemented a 15-month prospective study to assess the feasibility, effectiveness, safety, and client acceptability of a hybrid telemedicine model. In the model tested, doctors provided clinical guidance by reviewing client data and lab results, and authorized the procedure via telemedicine, while the nurses/midwives consulted with the client, provided medication at the health center, and conducted follow-up over the phone or in person. Service data record forms were completed using the REDCap online platform and client exit interviews were conducted after completion of the abortion. During implementation, 242 clients received medication abortion at the health centers, with 50% of clients interviewed during client exit interviews. The protocol ensured high adherence rates; 96% completed abortion. Post-procedure complications were rare (3%) and were largely managed at health centers with remote support from a medical doctor. Vaginal bleeding (36%) and abdominal pain (41%) were the prevalent side effects experienced by clients; only 10% of clients who reported side effects needed to see a provider for management. Overall client satisfaction with services was very high (98%) and the perceived quality of services was also very high (97–99%). We conclude that this hybrid telemedicine model for the provision of first-trimester medication abortion is feasible, effective, safe and accepted by clients. Results from this study will enable revisions to the abortion clinical guidelines to include task-sharing with mid-level providers, such as nurses and midwives, via telemedicine in health centers.

Feasibility of medication abortion self-care service delivery in Ghana

The increasing availability of medication abortion (MA) has significantly enhanced access to safe abortion services in many countries. As abortion medications become more accessible, it is essential to explore various models of care to ensure that MA is available to as many women in need as possible. This study aimed to document evidence regarding the feasibility of three models of care for providing MA utilising a combination of mifepristone and misoprostol: clinic-based, hybrid (a blend of clinic-based and home-based care), and full self-care (where women administer all medications at home without provider supervision). We interviewed 230 (80.7%) out of 285 women and girls who sought MA services within 5 months.We also conducted in-depth interviews with five (N=5) providers and 24 MA clients. The results revealed a high adoption rate for the hybrid self-care model (66%), followed by full self-care (28%). Many clients expressed satisfaction with the supportive care they received and indicated a willingness to recommend the service to others in their networks who might require medication for pregnancy termination. Notably, clients who utilised facility-based, hybrid, and full self-care models preferred to continue with the same approach for any future terminations. Only about 2.6% of clients reported experiencing incomplete abortions. Furthermore, the individual-level cost of self-managed abortion was substantially lower than that of hybrid and facility-based care. These findings contribute to the growing body of evidence on the feasibility and effectiveness of MA self-care and highlight the implications for program development.

Suitable Sweden: Co-producing Sweden Through Reproduction, Technological Development and International Aid in the Mid-twentieth Century.

In the mid-twentieth century, there were worries about overpopulation globally. Birth control - an often-sensitive topic - was made to be an issue of urgency through an overpopulation discourse. It stopped being associated mainly with sex and started to be associated with ending world starvation. Some nations were seen as requiring help; some nations were seen as politically sensitive to birth control; some nations were seen as financially capable; and other nations, such as Sweden, were seen as well suited for developing birth control technologies. This paper traces how Sweden became a main global protagonist in international aid that focused on reproduction through local birth control development. By using perspectives from science and technology studies, I examine the specific networks and actors that made birth control development and testing possible in Sweden in the mid-twentieth century. Centering around the testing of intrauterine devices and abortion pills in the 1960s, this paper shows how technological development in Sweden co-produced understandings of reproduction and the conditions for reproductive research infrastructure. It argues that the technological development of birth control is an important and yet understudied aspect of how Sweden situated itself internationally when it came to the overpopulation scare.

Impact of perilesional edema on severity of migraine in patients with calcified neurocysticercosis: A prospective evaluation.

Recent research has sparked increasing interest in the role of neuroinflammation in the pathogenesis of migraine. We hypothesize that perilesional edema, an imaging marker of inflammation caused by an immune response in the brain parenchyma surrounding calcified neurocysticercosis (NCC), may influence migraine pathophysiology. This study was designed to explore the potential impact of perilesional edema on migraine severity and treatment response. Cranial imaging of patients with primary headache may sometimes reveal calcified lesions indicative of calcified NCC. These lesions were once considered incidental and harmless findings. However, recent studies have shown that such calcifications are more frequently associated with headaches. Some research suggests that patients with calcified brain lesions experience more frequent and severe migraine compared to those without these lesions, though the pathophysiology underlying this association remains unclear. This single-center, prospective cohort study was conducted at King George Medical University, India, from September 2022 to September 2024. A total of 80 patients with migraine with calcified NCC were enrolled. Cranial magnetic resonance imaging with contrast was used to detect perilesional edema. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of perilesional edema. Both groups were assessed for migraine frequency, severity, and disability using standard scales. They were treated with standard migraine therapy and followed up for 3 months. Statistical analysis was performed to compare migraine characteristics, treatment responses, and disability between the two groups. Perilesional edema was observed in six of the 80 patients (7.5%). At presentation, Group A (those with perilesional edema) experienced more frequent migraine, with a mean (standard deviation [SD]) of 22.5 (4.4) days/month, compared to Group B (those without perilesional edema), which averaged 8.2 (2.7) days/month. The headaches in Group A were also more severe, as indicated by higher median visual analog scale scores (median [interquartile range, IQR] in Group A of 10.0 [8.5-10.0] and 7 [7.0-8.0] in Group B, p < 0.001). Disability scores were significantly higher in Group A, with higher median scores on the Migraine Disability Assessment Scale (median [IQR] score in Group A of 43 [40.5-48.5] and 21.5 [17.0-26.3] in Group B, p < 0.001) and six-item Headache Impact Test (median [IQR] score in Group A of 66 [64.25-71.23] and 57 [54.8-62.0] in Group B, p < 0.001) scales. Although both groups showed improvement over 3 months of treatment, Group A continued to experience greater migraine severity. In Group A, the mean (SD) headache frequency was 22.5 (4.4) at presentation, 14.0 (1.6) at 30 days, 10.7 (1.6) at 60 days, and 9.2 (2.0) at 90 days (p < 0.001). Similarly, in Group B, headache frequency decreased over time, with a mean (SD) of 8.2 (2.7) at presentation, 3.8 (1.7) at 30 days, 2.3 (1.0) at 60 days, and 1.9 (1.0) at 90 days (p < 0.001). After 30 days, there was a significant reduction in the use of abortive medications, with more patients in Group B (56/74 [76%]) showing a favorable response compared to Group A (2/6 [33%]; p = 0.046; odds ratio 0.16, 95% confidence interval 0.03-0.95). Our study found that among patients with migraine with calcified NCC, those with perilesional edema experienced more severe and harder-to-treat migraine compared to those without perilesional edema. These findings suggest that perilesional edema may influence the underlying mechanisms of migraine, leading to more severe migraine episodes.

ENXAQUECA E RISCO DE SUICÍDIO: UMA REVISÃO DE LITERATURA

Migraine, a highly prevalent and debilitating neurological condition worldwide, goes beyond physical impairment and profoundly affects the emotional sphere of patients. Recent studies have shown a significant association between migraine and increased risk of suicidal ideation and suicide attempts, especially in cases of migraine with aura. Psychiatric comorbidities, excessive use of abortive medications, and high frequency of migraine attacks exacerbate this vulnerability. This literature review aims to critically analyze current evidence on the relationship between migraine and suicidal behavior, identify specific risk factors, explore possible underlying neurobiological mechanisms, and discuss preventive and therapeutic strategies. Understanding this relationship is essential for clinical practice, broadening the management of migraine beyond pain control by incorporating a comprehensive approach to patients’ mental health.

Adverse reproductive outcomes in minors: New approaches to solving an old problem

Introduction. Teenage pregnancy is recognized by WHO as a serious public health problem, it is widespread throughout the world: both in developed and developing countries.Aim. To demonstrate the resources of the regional service of pediatric and adolescent gynecology to reduce unwanted reproductive outcomes in minors.Materials and methods. The study was conducted in obstetric hospitals of the Tyumen region, medical institutions providing outpatient gynecological care to minors. Contingent: 1703 minors with pregnancies completed in 2016–2023. Depending on the pregnancy outcome, the study contingent was divided into two groups. Group 1: 1,173 teenage girls with pregnancies that ended in childbirth. Group 2: 531 teenage girls with an abortive outcome of pregnancy. A separate review of clinical cases of ectopic pregnancy in minors is given (3 cases).Results. During the period under review, 156,747 pregnancies ended in childbirth in the Tyumen Region (excluding the KhantyMansi Autonomous Okrug – Yugra and the Yamalo-Nenets Autonomous Okrug). Over 6 years, there was a decrease from 23,791 to 17,164 births, i.e. by 27.9%. Statistics on childbirth and abortive outcomes in minors demonstrate a significant reduction in the number of completed pregnancies in minors: from 282 in 2016 to 175 in 2023 (-37.9%). The frequency of pregnancies with an abortive outcome in minors is higher than in adult women. Medical abortion accounts for almost ¾ of pregnancy terminations in minors. There is no significant decrease in the frequency of pregnancy terminations in adolescent girls among minors.Conclusion. A stable improvement in the situation in this area is possible provided that state programs (federal, regional) are developed and implemented, targeted funding for activities aimed at preserving the reproductive health of children and adolescents, and grant support for scientific research.

Management of anti-D prophylaxis in RhD negative women undergoing early medical abortion – an international practice survey among practitioners

Aim We evaluated the current practices of abortion providers giving anti-D prophylaxis to RhD negative women undergoing first trimester medical abortion and factors that influenced the decision. We also examined RhD management strategies that could be safely adopted. Methods A Steering Committee of abortion providers drafted a questionnaire on anti-D prophylaxis practices and perceptions. The 28-question survey, hosted online from December 2022 to December 2023, targeted international abortion providers. Results Almost 62% of respondents perform medical abortion during the first trimester (up to 12 weeks of amenorrhoea [WA]), while 32.8% provide it during the second trimester (13 to 26 WA). Among providers, 55.8% administer anti-D prophylaxis to all RhD negative women during first trimester medical abortions, 25.5% provide it selectively, and 18.6% do not administer it at all. Providers who do not administer IgG anti-D rely on national guidelines (51.2%), hospital protocols (16.3%), or both (7.0%), citing early gestational age (36.5%) and insufficient evidence (22.9%) as reasons. The primary reason for administering IgG anti-D was preventing risks in future pregnancies (52.7%). Yet, 59.1% expressed interest in changing their anti-D prophylaxis practices during early abortion. Conclusion This study highlights the huge variations in anti-D prophylaxis practices during first trimester medical abortion. These discrepancies mirror differences in national and international guidelines and underscore the need for robust clinical evidence to determine the gestational age limits for alloimmunization risk and support protocol updates.

Changes in abortion access after implementation of Medicaid coverage in Illinois: a retrospective analysis

IntroductionIn 2018, Illinois implemented House Bill 40 (HB-40), allowing state funds to provide Medicaid coverage for abortion. This study aimed to quantitatively measure changes in access among Illinois residents after...

The War on Drugs is a war on women: Louisiana's Abortion Law.

The War on Drugs is a war on women: Louisiana's Abortion Law.

Factors influencing abortion duration, bleeding volume, pain scores, and anxiety levels during medical abortion: a cross-sectional study

BackgroundSome factors that influence the medical abortion(MA) process are unknown. This study aims to investigate the influential factors associated with abortion time, bleeding volume, pain scores, and anxiety during the process of MA.MethodsA cross-sectional design was used in this research. Demographic information, pregnancy duration, bleeding volume, abortion duration, pain scores, anxiety levels, step count, and rate were recorded for each participant throughout MA. Data analysis was conducted using the SPSS version 26.0.ResultsThe mean age of the 450 women included in the study was 32.14 ± 5.57 years. The study revealed that older age correlates with longer abortion duration (rs = 0.102, P < 0.05) but lower pain scores during MA (rs=-0.178, P < 0.001). A history of dysmenorrhea shortened abortion time (rs=-0.097, P < 0.05) but increased pain (rs = 0.106, P < 0.05) and anxiety (rs = 0.119, P < 0.05). Women with cesarean section histories reported less pain (rs=-0.226, P < 0.001) and anxiety (rs=-0.129, P < 0.001) during MA. Vaginal delivery history decreased pain scores (rs=-0.117, P < 0.05) but did not significantly affect other outcomes. Previous surgical abortion alleviated pain (rs=-0.139, P < 0.001) and anxiety (rs=-0.093, P < 0.05) during MA. Increased walking steps or faster step rates shortened abortion duration (rs=-0.107, P < 0.05; rs=-0.133, P < 0.05) but raised pain scores (rs = 0.258, P < 0.001; rs = 0.235, P < 0.001).ConclusionsIndividuals with dysmenorrhea and high physical activity (PA)may have shorter abortion durations. Older individuals and those with cesarean or surgical abortion histories may experience less pain during medical abortion. Dysmenorrhea correlates with higher anxiety, while cesarean sections and surgery abortion lower it.Trial registrationThis research has been filed with the National Research Filing Center system under file number MR-44-24-032502.

Inducing fetal demise in a low-middle income country: A prospective cohort of intracardiac lidocaine versus intra-amniotic digoxin for inducing fetal demise before second-trimester medication abortion.

Inducing fetal demise in a low-middle income country: A prospective cohort of intracardiac lidocaine versus intra-amniotic digoxin for inducing fetal demise before second-trimester medication abortion.

Trends in Abortion Rates in Ontario, Canada

Following decades-long declines, significant increases in abortion rates have been reported in some jurisdictions from 2020 to 2023, but it is not yet known whether these trends are occurring in Canada. To assess abortion rates in Ontario from 2012 to 2022 and to examine trend changes associated with mifepristone availability, the COVID-19 pandemic, and postpandemic periods. This population-based interrupted time series cohort study examined all medication and procedural abortions provided in Ontario from January 1, 2012, to December 31, 2022, to females aged 15 to 44 years with provincial insurance coverage, identified using linked health administrative data that included records from practitioner billings, inpatient and outpatient hospital services, same-day surgeries, and outpatient prescription dispensations. Availability of mifepristone regulated as a normal (ie, prescribed by an authorized prescriber without additional certification or registration and dispensed by a pharmacist) prescription medication (in November 2017) and the COVID-19 pandemic period (from March 2020 to December 2021). The main outcome was the abortion rate (number of abortions per 1000 females per year) overall and within age strata, using an interrupted time series design. Of 422 867 medication and procedural abortions identified using data from health records of 225 540 reproductive-aged females (mean [SD] age, 28.5 [6.6] years), the abortion rate declined steadily from 15.6 abortions per year per 1000 females, aged 15 to 44 years, in 2012 to 12.3 in 2021 and then increased to 14.1 in 2022. When mifepristone was introduced in 2017 as a normal prescription medication, no immediate change in the abortion rate (-0.1 [95% CI, -0.7 to 0.8]) and a nonsignificant slope increase (0.6 [95% CI, -0.5 to 0.7]) were found. However, this trend resulted in an additional 1.5 (95% CI, 0.3-2.6) abortions per 1000 females by the first quarter of 2020 compared with premifepristone trends; rates increased more among those aged 15 to 19 years, less among those aged 35 to 44 years, and did not increase for those aged 25 to 29 years. During the pandemic period, abortion rates decreased by 1.2 (95% CI, -2.5 to -0.8), most pronounced among those aged 20 to 34 years. Compared with expected rates based on premifepristone trends, 5-year availability of normally prescribed mifepristone was associated with a rate difference of 1.9 (95% CI, 0.7-5.4) in 2022, with a greater increase among those aged 20 to 24 years (4.2 [95% CI, 1.5-9.0]) and no change among those aged 25 to 29 years (1.0 [95% CI, -1.7 to 6.2]). The increased abortion rate in 2022 was consistent with 5-year trends following normally prescribed mifepristone, although social forces potentially impacting international rates may have contributed. This study found that, following longstanding declines, abortion rates in Ontario gradually increased with mifepristone availability in 2017 in Ontario. Following a pandemic-related decrease in rates (in 2020 and 2021), substantial increases in abortion rates reported elsewhere from 2020 to 2023 did not occur in Ontario as of 2022, suggesting that Ontario's health services environment and Canada's regulatory and policy approach to preserving reproductive health services may have helped stabilize abortion rates. Future research is needed to understand how sociocultural changes affecting abortion service use elsewhere may be affecting contraception access and use and thus abortion rates in Canada.

Induced Abortion After Previous Caesarean Section: A Scoping Review.

Previous caesarean section (CS) is increasingly common among women undergoing induced abortion. To map and analyse existing literature on abortion safety, outcomes and management in those with previous CS. Four databases were systematically searched from inception to July 2024. Primary human studies in English reporting on outcomes, safety or management of first- or second-trimester medical (MToP) or surgical (SToP) abortion in women with previous CS were included. Uterine rupture incidence was analysed cumulatively in the first and secondtrimesters by the number of CS and the type of prostaglandin used. Data on the efficacy and safety of MToP and SToP, including studies reporting on the management of abortion in the setting of abnormal placentation, were collected and analysed by theme. In total, 164 articles met inclusion criteria. Incidence of uterine rupture in first-trimester MToP was 0 of 2194 cases, in second-trimester misoprostol MToP in those with 1 previous CS was 0.5% (10/1910) and 2.2% (18/835) in women with ≥ 2 CS (p < 0.001). Mifepristone priming did not increase the rupture rate in second-trimester MToP (p = 0.77). Previous CS was a modest risk factor for retained products after MToP across both trimesters (OR 1.48, CI 1.29-1.70). Medical and surgical abortion in the first and second trimester appears safe in women with prior CS; however, risks include uterine rupture, need for surgical intervention and haemorrhage from undiagnosed placenta accreta. Further research and guidance are needed on managing abortion after previous classical CS, ≥ 3 previous CS and those with abnormally invasive placenta.

Efficacy of a four-drug combined regimen compared to uterine curettage in the treatment of incomplete medical abortion: a prospective observational study

ObjectiveTo investigate the clinical efficacy of the combined regimen of four drugs (drospirenone and ethinylestradiol tablets (II), mifepristone, misoprostol, and Xinshenghua granules) for the treatment of incomplete medical abortion (MA).Methods184 patients diagnosed with incomplete MA were recruited and divided into two groups: the combined medication group (n = 92) and the uterine curettage group (n = 92). Patients in the combined medication group were treated with a combined regimen of four drugs, while those in the uterine curettage group were treated with uterine curettage.ResultsAfter treatment, the diameter of residue (0.00 VS 4.26 ± 2.34 mm, t=-3.359, P = 0.010), days of vaginal bleeding (9.79 ± 1.76 VS 11.92 ± 1.91 days, t=-4.688, P = 0.010) and return time of menses (28.58 ± 2.67 VS 31.24 ± 2.43 days, t=-4.238, P < 0.001) of the combined medication group were significantly lower than those of the uterine curettage group. The duration of menstruation (6.12 ± 1.12 VS 5.11 ± 0.98 days, t=-2.681, P = 0.007) and the proportion of menstrual volume equal to past menstruation after return of menses were higher in the combined medication group than in the uterine curettage group (80.43% VS 57.61%, χ2 = 16.472, P < 0.001). No statistically significant difference was observed between the two groups in terms of serum β-HCG levels after treatment (P > 0.05); the overall response rate was higher in the combined medication group than in the uterine curettage group (97.83% VS 80.43%, χ2 = 54.331, P < 0.001). No adverse reaction events occurred during the treatment.ConclusionThe combined regimen of four drugs boasts favorable efficacy for the treatment of incomplete MA, and is equally efficient as compared to uterine curettage.

Changes in local access to mifepristone dispensed by community pharmacies for medication abortion in Ontario: a population-based repeated cross-sectional study.

Although mifepristone for medication abortion has been available in Canada since a regulatory change in 2017, leading to its rapid uptake, the effects of this availability on regional access to abortion are unknown. We sought to examine how community pharmacy dispensation of mifepristone affected distribution of abortion services over time in Ontario, Canada. We used linked health administrative data to identify a cohort of all medication and procedural abortions provided in Ontario from 2017 to 2022, defined by outpatient mifepristone dispensations and abortion billing, diagnostic, and procedure codes. We evaluated changes over time in the annual proportion of community pharmacies that dispensed mifepristone and the availability and distribution of medication and procedural abortion services across geographic regions, defined by postal code forward sortation areas. In 2017, 2% of Ontario pharmacies filled 1 or more prescriptions for mifepristone, which increased to 20% in 2022. In 2017, few regions contained a mifepristone-dispensing pharmacy (19%) or procedural abortion service (18%). By 2022, most regions had local access to a mifepristone-dispensing pharmacy (77%), with geographically distributed abortion services across Ontario. Although only 37% of abortion service users lived in a region with either a mifepristone-dispensing pharmacy or procedural provider in 2017, this increased to 91% by 2022. Access to medication abortion across Ontario increased substantially within 5 years of mifepristone's availability as a normally prescribed and dispensed medication. This regulatory approach appears successful for achieving widespread access to local abortion services.

INFLUENCE OF HYPERPROLIFERATIVE UTERINE DISEASES ON THE COURSE OF THE FIRST TRIMESTER OF PREGNANCY

The impact of hyperproliferative uterine diseases (HPD), including uterine leiomyoma (LM), uterine endometriosis (adenomyosis) (A), and endometrial hyperplastic processes (such as polyps and/or endometrial hyperplasia (PE and/or GE)) present prior to pregnancy, particularly their combination, on pregnancy outcomes remains a pressing issue in modern medicine. Over the past decade, there has been a significant increase in the number of pregnant women with endometriosis, LM, and a history of PE and/or GE. Aim of the study: To investigate the characteristics of pregnancy course in women with hyperproliferative uterine diseases. Materials and methods. A prospective cohort randomized study was conducted among 680 women treated at the Department of Purulent-Inflammatory Diseases in Obstetrics and the Department of Rehabilitation of Women's Reproductive Function at the State Institution "All-Ukrainian Center for Motherhood and Childhood of the National Academy of Medical Sciences of Ukraine" from January 2018 to December 2024. Group 1 included 517 pregnant women with HPD and their combinations (LM, A, PE and/or GE). Group 2 (comparison group) consisted of 82 pregnant women without HPD but with pregnancy complications. Group 3 (control group) included 81 pregnant women without HPD and without pregnancy complications. Results. Early pregnancy loss was observed in 68.2% of pregnant women with HPD, while 36.6% of patients had a history of induced or medical abortions, and 27.2% exhibited a combination of complications from previous pregnancies. A high frequency of uterine wall curettage was also noted in the medical history of pregnant women with HPD (88.6%). During the first trimester, the threat of early miscarriage was present in 90% of pregnant women with HPD (OR = 3.922; 95% CI: 2.261–6.802). Retrochorial hematoma was detected twice as often in Group 1 compared to the comparison group (OR = 2.519; 95% CI: 1.418–4.473), and low placentation was observed in 18.9% of women in Group 1 (OR = 2.163; 95% CI: 1.010–4.635). These complications were more prevalent in pregnant women with a combination of adenomyosis and other uterine fibroids. Conclusions. Pregnancy in women with hyperproliferative uterine diseases (LM, A, PE and/or GE present prior to pregnancy) is frequently complicated during the first trimester by the threat of early miscarriage, retrochorial hematoma, and low placentation.

Nurse practitioner medication abortion providers in Canada: results from a national survey

BackgroundIn 2017, nurse practitioners (NPs) became the first non-physician healthcare providers authorised to independently provide medication abortion (MA) in Canada. We aimed to report on demographic and clinical characteristics of...

Mapping Access to Medication Abortion in Maputo, Mozambique.

Mapping Access to Medication Abortion in Maputo, Mozambique.

Learning from medication abortion: repeat doses of misoprostol after mifepristone for early pregnancy loss management

Learning from medication abortion: repeat doses of misoprostol after mifepristone for early pregnancy loss management