First-trimester medical abortion

2014 ◽  
Vol 63 (6) ◽  
pp. 66-86
Author(s):  
Gennadiy Tikhonovich Sukhikh ◽  
Vladimir Nikolaevich Serov ◽  
Vera Nikolaeva Prilepskaya ◽  
Natal'ya Eknikovna Khan ◽  
Viktor Leonidovich Tutunnik ◽  
...  
Keyword(s):  
Russian Federation ◽  
Work Group ◽  
Pregnancy Termination ◽  
Medical Abortion ◽  
First Trimester ◽  
Cochrane Library ◽  
Clinical Protocol ◽  
Safe Abortion ◽  
The Russian Federation ◽  
The Cochrane Library

The Clinical Protocol “First-Trimester Medical Abortion” is written in accordance with the Russian laws on health protection, Procedure on medical care provision to women seeking for artificial termination of pregnancy, Law on drug circulation. The evidential base for the clinical protocol was constituted by the publications included in the Cochrane Library, PUBMED and MEDLINE databases, by the results of the Russian clinical studies on the medical abortion carried out with the permission of the Ethical Committee of the Ministry of Healthcare of the Russian Federation, by the Russian and international regulatory documents on safe abortion (FDA, HAS). The objective of these clinical protocol is to improve the quality of medical aid in the Russian Federation provided during early pregnancy termination. The comments were discussed jointly by the work group members; a consensus was reached on the key questions of the clinical protocol and practical recommendations were developed.

scholarly journals Possibilities of visualization as a lean method in the management of medical organizations

2019 ◽  
Vol 10 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Albert A. Kurmangulov ◽  
Julia S. Reshetnikova ◽  
Roman N. Bagirov ◽  
Olga I. Frolova ◽  
Natalya S. Brynza
Keyword(s):  
Health Care ◽  
Russian Federation ◽  
Imaging Techniques ◽  
Cochrane Library ◽  
Methodological Framework ◽  
Review Of Literature ◽  
Historical Aspect ◽  
The Russian Federation ◽  
Visualization Tools ◽  
The Cochrane Library

The article presents the results of a review of literature on the possibility of visualization in the health care system of the Russian Federation as one of the main methods of implementation of lean production. The historical aspect of the use of various imaging techniques in medicine is reflected in detail, as well as the advantages of some visualization tools in the organization of medical care. The existing legal and methodological framework for the use of visualization in the activities of medical organizations of various profiles is analyzed. Search publications carried out on the bases e-library, Medline, Scopus, Pub Med, The Cochrane Library and RINC.

Current relevance of non-invasive prenatal study of cell-free fetal DNA in the mother’s blood and prospects for its application in mass screening of pregnant women in the Russian Federation

2021 ◽  
Vol 70 (1) ◽  
pp. 19-50
Author(s):  
Elena A. Kalashnikova ◽  
Andrey S. Glotov ◽  
Elena N. Andreyeva ◽  
Ilya Yu. Barkov ◽  
Galina Yu. Bobrovnik ◽  
...  
Keyword(s):  
Mass Screening ◽  
Russian Federation ◽  
Prenatal Screening ◽  
First Trimester ◽  
Screening Programs ◽  
Non Invasive ◽  
Fetal Dna ◽  
Prenatal Diagnostic ◽  
Cell Free Fetal Dna ◽  
The Russian Federation

This review article offers an analysis of application of cell-free fetal DNA non-invasive prenatal screening test for chromosome abnormalities in the mothers blood in different countries. The diagnostic capacities of the method, its limitations, execution models and ethical aspects pertinent to its application are discussed. The data for the discordant results is shown and analyzed. The advantages of the genome-wide variant of cell-free fetal DNA analysis and the problems concerning its application in the mass screening are described. The main suggestion is to implement the contingent cell-free fetal DNA testing model for the common trisomies (for the chromosomes 21, 18 and 13) into the prenatal diagnostic screening programs in the Russian Federation. This novel model is based on the results of the mass combined first trimester prenatal screening in four federal subjects of the country completed by 2019 and is offered as an additional screening in the mid-level risk group (with cut-off from 1 : 100 to 1 : 500 or from 1 : 100 to 1 : 1000) defined according to the first trimester prenatal screening results. The basic requirements for the implementation of the contingent model in the Russian Federation are stated.

scholarly journals Early pregnancy termination with a simplified mifepristone: Medical abortion outpatient regimen

1970 ◽  
Vol 7 (3) ◽  
pp. 209-212 ◽  
Author(s):  
N Chuni ◽  
TS Chandrashekhar
Keyword(s):  
Pregnancy Termination ◽  
Medical Abortion ◽  
Global Public Health ◽  
Public Health Importance ◽  
Safe Abortion ◽  
Nulliparous Women ◽  
Oral Misoprostol ◽  
Medical Termination ◽  
A Prospective Study ◽  
Home Administration

Background: An estimated 30 million abortions are performed worldwide every year. Many women do not have access to abortion and die of complications after illegal abortions. Medical abortion could provide greater access to safe abortion services; availability of the procedure is, therefore, of global public health importance. Aim: The aim was to study the efficacy of lowered dose of Mifepristone in medical abortion. Materials and methods: One hundred and twelve cases with a pregnancy of 63 days duration or less were enrolled in a prospective study using a lowered dose of 200mg Mifepristone followed, 48 hours later, by home administration of 400μg Misoprostol orally. At the second visit, on day 15, outcome and adverse effects were analysed. Women who failed to undergo a complete abortion were further managed by surgical evacuation of uterus. Results: The mean gestational age was 50.6 days. The rates of complete abortion were 92.8%, 83 % and 80 % in the ≤49 days group, 50 to 56 days and 57 to 63 days group respectively. Vaginal bleeding emerged as the biggest reason for medically indicated termination. Nulliparous women had a greater frequency of side effects, though values did not reach statistical signifi cance. Conclusion: This regimen of a lower dose of 200mg Mifepristone, followed by home administration of 400μg oral Misoprostol 48 hours later is safe and highly effective especially in pregnancies of up to 49 days duration. Key words: Mifepristone; Medical termination of pregnancy (MTP) DOI: 10.3126/kumj.v7i3.2725 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 209-212

scholarly journals A retrospective study of efficacy and cost efficiency of medical vs. surgical management of abortions in first trimester

2021 ◽  
Vol 10 (9) ◽  
pp. 3429
Author(s):  
Meetangi Agarwal ◽  
Sailatha Ramanujam ◽  
Anuradha C. Ramachandran
Keyword(s):  
Success Rate ◽  
Pregnancy Termination ◽  
Transvaginal Ultrasound ◽  
Cost Effective ◽  
Medical Abortion ◽  
First Trimester ◽  
Observational Research ◽  
Medical Termination ◽  
Significant Difference

Background: The aim of the study was to assess and comparatively evaluate the efficacy of different methods of first trimester abortions (medical, surgical) in terms of its safety, cost and effectiveness.Methods: We present a retrospective observational research study done at Chettinad hospital and research institute, Kelambakkam Chennai which included a total of 70 patients of first trimester abortions, in the period from June 2019 to June 2020. 55 patients were offered medical treatment (MTOP) and were followed up with a repeat scan after 2 weeks. In cases of failed medical abortion patient underwent curettage. Though, in some cases after an attempt at medical abortion, if the products didn’t expel at all within 48 hours, dilatation and evacuation was offered. Transvaginal ultrasound was performed to confirm the success of the treatment. In 15 cases who presented with incomplete abortion, surgical treatment (STOP) was offered. The outcomes considered were successful complete abortions, failed medical abortions, side effects and complications including blood transfusion.Results: The baseline characteristics of women were similar in both the groups like mean age, parity, history of previous termination of pregnancy (TOP). The success rate in MTOP was 67.2% and in STOP 100%.The amount of bleeding experienced was moderate to heavy in MTOP and minimal to moderate in STOP.37 women who underwent only medical termination who returned for the 2-week follow-up, the rate of complete pregnancy termination was 94% and for the remaining 2 women surgical intervention was required. In the surgical group, at the 2-week follow up, no woman underwent a repeat vacuum aspiration with an efficacy of 100%. No significant difference was found in the mean total cost for the medical and surgical groups after adding the subsequent costs (including additional manual vacuum evacuation).Conclusions: Medical termination of abortion should be preferred over surgical termination as it is safer, cost effective, with fewer complications and high success rate. 

scholarly journals Second-trimester medication abortion outside the clinic setting: an analysis of electronic client records from a safe abortion hotline in Indonesia

2018 ◽  
Vol 44 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Caitlin Gerdts ◽  
Ruvani T Jayaweera ◽  
Sarah E Baum ◽  
Inna Hudaya
Keyword(s):  
Medical Care ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Warning Signs ◽  
Care Seeking ◽  
Safe Alternative ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Termination Status ◽  
Lost To Follow Up

IntroductionUnsafe abortion past the first trimester disproportionately accounts for the majority of global abortion-related morbidity and mortality; research that documents the safety, feasibility and acceptability of existing models for providing information and support to women who self-manage outside of formal clinic settings is needed.MethodsThis study is a retrospective analysis of anonymised electronic client records from callers to a safe abortion hotline in Indonesia. Between July 2012 and October 2016, a total of 96 women contacted the hotline for information on medication abortion beyond 12 weeks' gestation and are included in this study. Descriptive statistics were calculated regarding pregnancy termination status, client experience with warning signs of potential complications, and medical care seeking and treatment.ResultsNinety-six women with pregnancies beyond the first trimester called the hotline for information on medication abortion; 91 women received counselling support from the hotline. Eighty-three women (91.2%) successfully terminated their pregnancies using medication and did not seek medical care. Five women exhibited warning signs of potential complications and sought medical care; one woman sought care after a failed abortion. Two women were lost to follow-up and the outcomes of their pregnancies are unknown.ConclusionsEvidence from our analysis suggests that a model of remote provision of support for abortions later in pregnancy by non-medically trained, skilled abortion counsellors could be a safe alternative for women in need of abortions beyond 12 weeks' gestation in a legally restrictive context. Further examination and documentation of the model is warranted.

scholarly journals Progesterone-related changes in pro-inflammatory cytokines in recurrent miscarriage

2004 ◽  
Vol 53 (4) ◽  
pp. 59-61
Author(s):  
V. E. Radzinsky ◽  
E. Y. Zapertova
Keyword(s):  
Russian Federation ◽  
Birth Rate ◽  
Negative Impact ◽  
Recurrent Miscarriage ◽  
Married Couples ◽  
First Trimester ◽  
The Usa ◽  
The Russian Federation ◽  
Genetically Determined ◽  
Pro Inflammatory Cytokines

Habitual miscarriage (RMP) is a multifactorial, genetically determined disease. The NSP problem remains one of the most pressing problems in obstetrics and gynecology, as it entails not only a decrease in the birth rate, but also has a negative impact on the reproductive health of women. The frequency of spontaneous miscarriages ranges from 15 to 20% of desired pregnancies (Sidelnikova V.M., 2002). According to the Collegium of the Ministry of Health of the Russian Federation (2002), 50% of miscarriages occur in the first trimester, 25% of them occur in PNL. Moreover, every fifth desired pregnancy is interrupted spontaneously in the Russian Federation, which leads not only to medical but also demographic losses - 180,000 desired children are not born in the country. In the USA, habitual pregnancy loss (recurrent miscarriage) is diagnosed after three or more spontaneous abortions in a row and is observed in 1% of all married couples (Lee R.M., 2000).

Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences

2009 ◽  
Vol 18 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Giovanni Santone ◽  
Gianmatteo Ricchi ◽  
David Rocchetti ◽  
Stefania Tofani ◽  
Cesario Bellantuono
Keyword(s):  
Risk Factor ◽  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Antidepressant Drugs ◽  
First Trimester ◽  
Cochrane Library ◽  
Control Group ◽  
Search Terms ◽  
First Trimester Of Pregnancy ◽  
The Cochrane Library

SUMMARYAim– To review studies conducted to establish the risk of spontaneous abortion (SA) in women exposed to anti-depressant drugs (ADs) during early pregnancy.Methods– By using different search terms, PubMed, Toxline, EMBASE, PsychINFO, and the Cochrane library databases were searched from January 1980 to March 2008, to identify studies assessing the risk of SA in women exposed to different classes of ADs during the first trimester of pregnancy.Results– Ten studies over 21 identified were selected for the analysis. All were performed prospectively and included as control group unexposed women, or exposed to non-teratogenic drugs or to placebo. In seven studies a depressive episode was specified as the reason for which the drug was prescribed, while the time of exposure was in nine.Conclusions– Only three studies over ten selected reported a significant association between an increased rate of SAs and early pregnancy exposure to some ADs. Many methodological flaws in the study design were found in all studies considered. Given this background and a lack of strong evidence on this issue, further prospective and better designed studies are needed to assess the risk of SA in pregnant women exposed to ADs against the risk of an untreated maternal depression.Declaration of Interest:None.

Abortion

2019 ◽  
Author(s):  
Nisha Verma ◽  
Siripanth Nippita
Keyword(s):  
Pregnancy Termination ◽  
Healthcare Providers ◽  
Medical Abortion ◽  
First Trimester ◽  
The United States ◽  
Decision Making Process ◽  
Basic Information ◽  
Second Trimester ◽  
Dilation And Curettage ◽  
Cervical Preparation

Individuals may have a variety of reasons to end a pregnancy. Healthcare providers should provide support during the decision-making process and should be able to give patients basic information about their options depending on gestational age. In the United States, clinicians can offer first-trimester medical abortion with mifepristone and misoprostol up to 10 weeks’ gestation. Uterine aspiration or dilation and curettage are options throughout the first trimester. Options in the second trimester include induction abortion with medications, or a surgical procedure (dilation and evacuation) which may require cervical preparation at later gestational ages. Clinicians should assess the patient’s desire for fertility following an abortion and may offer contraception or preconception advice, as appropriate. This review contains 13 figures, 6 tables, and 61 references. Key Words: abortion, dilation and curettage, dilation and evacuation, mifepristone, misoprostol, pregnancy termination

Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13+6 weeks’ gestation: a systematic review and new NICE consensus guidelines

2020 ◽  
pp. bmjsrh-2019-200536 ◽  
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
James Hawkins ◽  
Sharon Cameron ◽  
Anuja Pandey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effect ◽  
Random Effect Model ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Clinical Expertise ◽  
Effect Model ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Surgical Abortion

BackgroundIn order to develop the 2019 National Institute for Health and Care Excellence (NICE) national guideline on abortion care for the National Health Service1 we undertook a systematic review comparing anti-D prophylaxis to no prophylaxis in rhesus D (RhD)-negative women undergoing medical or surgical abortion of pregnancy at ≤13+6 weeks’ gestationMethodsWe searched Embase, Medline and the Cochrane Library on 19 October 2018. We also consulted experts and checked reference lists for any missed trials. Eligible studies were randomised controlled trials and non-randomised comparative studies, published in English from 1985 onwards, comparing anti-D prophylaxis to no anti-D prophylaxis in RhD-negative women undergoing medical or surgical abortion at ≤13+6 weeks’ gestation, and reporting subsequent anti-D isoimmunisation/sensitisation or subsequent affected pregnancy. These outcomes were to be analysed as risk ratios in Review Manager 5.3 using the Mantel-Haenszel statistical method and a fixed or random effect model. The overall quality of the evidence was planned to be assessed using GRADE.ResultsThe search identified 426 potentially relevant studies of which none met the inclusion criteria. Recommendations for practice were therefore based on the clinical expertise of the guideline committee.Conclusions(1) Offer anti-D prophylaxis to women who are Rhesus D negative who are having an abortion after 10+0 weeks’ gestation. (2) Do not offer anti-D prophylaxis to women who are having a medical abortion up to and including 10+0 weeks’ gestation. (3) Consider anti-D prophylaxis for women who are rhesus D negative and are having a surgical abortion up to and including 10+0 weeks’ gestation.

scholarly journals Prospective study to compare the efficacy of vaginal misoprostol for first trimester MTP before six weeks and up to 9 weeks

2021 ◽  
Vol 10 (3) ◽  
pp. 1116
Author(s):  
Paresh N. Sheth
Keyword(s):  
Prospective Study ◽  
Gestational Age ◽  
Pregnancy Termination ◽  
Tertiary Care ◽  
Medical Abortion ◽  
First Trimester ◽  
Care Hospital ◽  
Surgical Interventions ◽  
Vaginal Misoprostol ◽  
Group B

Background: Misoprostol is prostaglandin E1 analogue that has been used for medical abortion. MTP has been legalized in India since 1971. Medical abortion refers for early pregnancy termination performed without any primary surgical interventions, usually before 9 weeks (63 days) gestational age. This prospective study was conducted to compare the efficacy of vaginal misoprostol for abortion in women at a gestational age of <6 weeks (42 days) and in woman up to 9 weeks (63 days) gestational age.Methods: This is a prospective study of total 130 women seeking medical termination of pregnancy up to 9 weeks (63 days) gestational age at obstetrics and gynecology department, at a tertiary care hospital Gujarat, India, from May 2018 to May 2019.Results: In result study the overall complete abortion rate was 91.54% In Group A (<6 weeks) complete abortion occurred in 93.3% women. Whereas in Group B (6 to 9 weeks) complete abortion occurred in 90% of women. The two groups did not differ significantly with respect to side effects. Overall, 91.3% women were satisfied with this method and will choose it again if required.Conclusions: This study shows that vaginal misoprostol alone regimen is highly effective and well tolerated method in Indian women requiring MTP up to 63 days gestational age. However better efficacy maybe achieved at gestational age < 6 weeks (42 days). 

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