American journal of obstetrics and gynecology
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As early medical abortion becomes more widespread in the United States, those who wish to provide it need to understand how existing abortion restrictions apply to this procedure. Although these laws were written with a primary regard for surgical procedures, most will be broadly applicable to the provision of medical abortion as well. ⋯ We discuss the applicability of such requirements to medical abortions and describe how providers of medical abortion can comply. Finally, we address potential legislative and regulatory changes that could help to make medical abortion more widely accessible to women in the United States.
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Am. J. Obstet. Gynecol. · Aug 2000
ReviewAbortion with mifepristone and misoprostol: regimens, efficacy, acceptability and future directions.
Mifepristone at a dose of 600 mg followed by 400 microg misoprostol orally has been used for early abortion by hundreds of thousands of women with success rates at =49 days' gestation ranging from 92% to 97%. Newer regimens may prove simpler than this standard regimen and may serve a larger number of patients. Vaginal rather than oral administration of misoprostol may have advantages, including improvement in the efficacy of mifepristone regimens at >49 days' gestation. ⋯ Although most research protocols have used ultrasonography to confirm gestational age, the method can be provided safely without routine reliance on ultrasonography. Acceptability of the method to care providers and to patients has been high in all studies. The introduction of medical abortion into general medical practice in the United States will teach us much about the practical aspects of service provision.
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Am. J. Obstet. Gynecol. · Aug 2000
ReviewAlternatives to mifepristone regimens for medical abortion.
Alternatives to regimens with mifepristone and a prostaglandin analog for medical abortion emerged because of the need for accessible, effective, and safe options in areas of the world where mifepristone was unavailable. Studies of oral or intramuscular methotrexate combined with misoprostol have demonstrated complete abortion rates in the same range as mifepristone regimens at =49 days' gestation. ⋯ Recent reports suggest that misoprostol alone may have similar efficacy, but with significantly higher rates of side effects. Randomized trials are needed to directly compare the clinical efficacies and acceptabilities of available medical abortion regimens.