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https://www.readbyqxmd.com/read/29023594/first-trimester-medication-abortion-practice-in-the-united-states-and-canada
#1
Heidi E Jones, Katharine O'Connell White, Wendy V Norman, Edith Guilbert, E Steve Lichtenberg, Maureen Paul
We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated...
2017: PloS One
https://www.readbyqxmd.com/read/29020779/management-of-medical-termination-of-pregnancy-mtop-up-until-the-7th-week-of-gestation-in-the-czech-republic
#2
P Slunska, J Hanacek, M Fanta, B Sehnal, R Gerychová, A Hola, A Zdenkova, H Neumannová, M Dziakova, M Lubusky
OBJECTIVE: In the Czech Republic (CR), it is possible, to carry out Medical Termination of Pregnancy (MToP) in the 1st trimester since June 2014, in case a woman submits a written request for it and in case the ultrasound examination confirms an intrauterine singleton prosperous pregnancy, between day 42 and 49 of gestation, crown-rump length (CRL) of the embryo 2-9 mm. The aim of the study is to analyze the management of MToP up until the 7th week of gestation in five centres in the CR...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29020778/-management-of-medical-termination-of-pregnancy-mtop-up-until-the-7th-week-of-gestation-in-the-czech-republic
#3
P Slunska, J Hanacek, M Fanta, B Sehnal, R Gerychová, A Hola, A Zdenkova, H Neumannová, M Dziakova, M Lubusky
OBJECTIVE: In the Czech Republic (CR), it is possible, to carry out Medical Termination of Pregnancy (MToP) in the 1st trimester since June 2014, in case a woman submits a written request for it and in case the ultrasound examination confirms an intrauterine singleton prosperous pregnancy, between day 42 and 49 of gestation, crown-rump length (CRL) of the embryo 2-9 mm. The aim of the study is to analyze the management of MToP up until the 7th week of gestation in five centres in the CR...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29018067/post-abortion-care-with-misoprostol-equally-effective-safe-and-accepted-when-administered-by-midwives-compared-to-physicians-a-randomised-controlled-equivalence-trial-in-a-low-resource-setting-in-kenya
#4
Marlene Makenzius, Monica Oguttu, Marie Klingberg-Allvin, Kristina Gemzell-Danielsson, Theresa M A Odero, Elisabeth Faxelid
OBJECTIVE: To assess the effectiveness of midwives administering misoprostol to women with incomplete abortion seeking post-abortion care (PAC), compared with physicians. DESIGN: A multicentre randomised controlled equivalence trial. The study was not masked. SETTINGS: Gynaecological departments in two hospitals in a low-resource setting, Kenya. POPULATION: Women (n=1094) with incomplete abortion in the first trimester, seeking PAC between 1 June 2013 to 31 May 2016...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28989918/serum-%C3%AE-hcg-concentration-is-a-predictive-factor-for-successful-early-medical-abortion-with-vaginal-misoprostol-within-24-hours
#5
Jung In Kim, In Yang Park, Jung Mi Yim, Ju Young Cheon, Hang Goo Yun, Ji Young Kwon
OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28982101/misoprostol-prior-to-diagnostic-office-hysteroscopy-in-the-subgroup-of-patients-with-no-risk-factors-for-cervical-stenosis-a-randomized-double-blind-placebo-controlled-trial
#6
Usama M Fouda, Khaled A Elsetohy, Hesham S Elshaer, Bahaa Eldin M Hammad, Mona M Shaban, Mohamed A Youssef, Ahmed T Hashem, Ahmed H Attia
AIMS: To assess the effectiveness of vaginal misoprostol in minimizing the pain perceived by patients with no risk factors for cervical stenosis (i.e., parous women of reproductive age who have no history of cesarean section or cervical surgery) during diagnostic office hysteroscopy. METHODS: A total of 100 patients with no risk factors for cervical stenosis were randomized to the misoprostol group (n = 50) or the placebo group (n = 50). In the misoprostol group, 2 misoprostol tablets (400 µg) were administered vaginally 12 h before office hysteroscopy...
October 6, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28969481/delivery-through-cervicovaginal-fistula-literature-review-and-case-report
#7
Rafał Watrowski, Burghardt Babbel, Gerald Gitsch
Less than 10 deliveries via cervicovaginal fistula (CVF) with closed cervical os were reported so far. In the majority of cases, the patients had a history of induced abortions. The CVF was usually recognized due to postpartum hemorrhage. The facilitating role of prostaglandins used for labor induction was supposed. In all cases, the babies remained unaffected by the delivery route. We report a new case of a 37 years old gravida 2, para 0, with a history of a paracervical tear following a first trimester abortion 11 years ago...
October 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28964589/global-regional-and-subregional-classification-of-abortions-by-safety-2010-14-estimates-from-a-bayesian-hierarchical-model
#8
Bela Ganatra, Caitlin Gerdts, Clémentine Rossier, Brooke Ronald Johnson, Özge Tunçalp, Anisa Assifi, Gilda Sedgh, Susheela Singh, Akinrinola Bankole, Anna Popinchalk, Jonathan Bearak, Zhenning Kang, Leontine Alkema
BACKGROUND: Global estimates of unsafe abortions have been produced for 1995, 2003, and 2008. However, reconceptualisation of the framework and methods for estimating abortion safety is needed owing to the increased availability of simple methods for safe abortion (eg, medical abortion), the increasingly widespread use of misoprostol outside formal health systems in contexts where abortion is legally restricted, and the need to account for the multiple factors that affect abortion safety...
September 27, 2017: Lancet
https://www.readbyqxmd.com/read/28963922/risk-of-maternal-fetal-and-neonatal-complications-associated-with-the-use-of-the-transcervical-balloon-catheter-in-induction-of-labour-a-systematic-review
#9
REVIEW
Jip S M Gommers, Milou Diederen, Chris Wilkinson, Deborah Turnbull, Ben W J Mol
Induction of labour is one of the most frequently applied obstetrical interventions globally. Many studies have compared the use of balloon catheters with pharmacological agents. Although the safety of the balloon catheter is often mentioned, little has been written about the total spectrum of maternal and fetal morbidity associated with induction of labour using a balloon catheter. We evaluated the safety of labour induction with a transcervical balloon catheter by conducting a literature review with pooled risk assessments of the maternal, fetal and neonatal morbidity...
September 18, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28941978/barriers-to-accessing-abortion-services-and-perspectives-on-using-mifepristone-and-misoprostol-at-home-in-great-britain
#10
Abigail R A Aiken, Katherine A Guthrie, Marlies Schellekens, James Trussell, Rebecca Gomperts
OBJECTIVE: To examine reasons for seeking abortion services outside the formal healthcare system in Great Britain, where abortion is legally available. STUDY DESIGN: We conducted a mixed-methods study among women resident in England, Scotland, and Wales who requested at-home medication abortion through online telemedicine initiative Women on Web (WoW) between November 22nd 2016 and March 22nd 2017. We examined the demographics and circumstances of all women requesting early medication abortion and conducted a content analysis of a sample of their anonymized emails to the service to explore their reasons for seeking help...
September 18, 2017: Contraception
https://www.readbyqxmd.com/read/28935220/efficacy-of-medical-abortion-prior-to-six-gestational-weeks-a-systematic-review
#11
Nathalie Kapp, Maureen K Baldwin, Maria Isabel Rodriguez
OBJECTIVE: To describe the efficacy of medical abortion using mifepristone and misoprostol for gestations less than 6weeks. STUDY DESIGN: We searched PubMed and Cochrane databases for articles in any language that examined the success of mifepristone and misoprostol abortion at gestational ages<42days. Data was independently abstracted by two authors, and graded for evidence quality. A pooled analysis of efficacy and a summary odds ratio of abortion failure of<42days gestation compared with gestational week 42-49days was performed for randomized trials as well as for prospective studies...
September 18, 2017: Contraception
https://www.readbyqxmd.com/read/28935219/medical-abortion-can-be-provided-safely-and-effectively-by-pharmacy-workers-trained-within-a-harm-reduction-framework-nepal
#12
Anand Tamang, Mahesh Puri, Sazina Masud, Deepak Kumar Karki, Diksha Khadka, Minal Singh, Poonam Sharma, Subash Gajurel
OBJECTIVES: To examine the treatment efficacy, safety and satisfaction of women using medical abortion (MA) pills provided by pharmacists following an education intervention based on a harm reduction approach. STUDY DESIGN: This was an operations research study over a six-month period in 2015, using a non-inferiority design. We provided training to dispense MA pills, based on a harm reduction approach, to a group of pharmacy workers in Makwanpur district (GROUP 2)...
September 18, 2017: Contraception
https://www.readbyqxmd.com/read/28934082/evaluation-of-adherence-to-french-clinical-practice-guidelines-in-the-management-of-pregnancy-loss-issued-by-the-french-college-of-obstetricians-and-gynecologists-one-year-after-publication-a-vignette-based-study
#13
S Le Gouic, V Lavoué, M Mimouni, J Levêque, C Huchon
OBJECTIVES: To assess the adhesion of French obstetricians and gynecologists to the French clinical practice guidelines for pregnancy loss, issued by the French College of Obstetricians and Gynecologists, one year after publication. METHODS: An online vignette-based study was emailed to a sample of French obstetricians and gynecologists to compare their management of women with missed early miscarriage and incomplete early miscarriage. A descriptive statistical analysis was performed comparing the rates of appropriate management for these two indications before and after the release of the guidelines...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28930621/the-incidence-of-menstrual-regulation-procedures-and-abortion-in-bangladesh-2014
#14
Susheela Singh, Altaf Hossain, Isaac Maddow-Zimet, Michael Vlassoff, Hadayeat Ullah Bhuiyan, Meghan Ingerick
CONTEXT: Menstrual regulation (MR) has been part of the Bangladesh family planning program since 1979. However, clandestine abortion remains a serious health problem in Bangladesh, and anecdotal reports indicate that clandestine use of misoprostol has increased since the most recent estimates (for 2010). Because of this, it is important to assess changes in the use of MR services and the incidence of clandestine abortion since 2010. METHODS: A survey of a nationally representative sample of 829 health facilities that provide MR or postabortion care services and a survey of 322 professionals knowledgeable about these services were conducted in 2014...
March 21, 2017: International Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28922193/update-on-second-trimester-medical-abortion
#15
Klaira Lerma, Kate A Shaw
PURPOSE OF REVIEW: To review recent literature on second trimester abortion with medical methods. RECENT FINDINGS: Across studies published in the recent past, it is apparent that women prefer shorter procedures and procedure times. Several randomized controlled trials have confirmed adding mifepristone to the second trimester medication abortion regimen results in shorter abortion intervals from first misoprostol administration to complete fetal expulsion. A study of simultaneous administration of mifepristone and misoprostol yielded shorter mean 'total' abortion times, presenting several logistical advantages...
September 15, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28910848/misoprostol-in-addition-to-a-double-balloon-catheter-for-induction-a-double-blind-randomized-controlled-trial
#16
Meghan G Hill, Maritza G Gonzalez, Wei-Hsuan Lo-Ciganic, Kathryn L Reed
No abstract text is available yet for this article.
September 14, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28901007/pharmacological-and-mechanical-interventions-for-labour-induction-in-outpatient-settings
#17
REVIEW
Joshua P Vogel, Alfred O Osoti, Anthony J Kelly, Stefania Livio, Jane E Norman, Zarko Alfirevic
BACKGROUND: Induction of labour is carried out for a variety of indications and using a range of methods. For women at low risk of pregnancy complications, some methods of induction of labour or cervical ripening may be suitable for use in outpatient settings. OBJECTIVES: To examine pharmacological and mechanical interventions to induce labour or ripen the cervix in outpatient settings in terms of effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28893657/the-effect-of-adjuvant-treatment-to-prevent-and-treat-intrauterine-adhesions-a-network-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
Yu Yan, Dongmei Xu
Intrauterine adhesions (IUA) can lead to partial or complete closure of the uterine cavity, which may result in symptoms including abnormal menstruation, infertility, and pelvic pain. A network meta-analysis was performed to assess the effect of adjuvant therapy on the prevention and treatment of intrauterine adhesions. We searched electronic databases, including PubMed, EmBase, and the Cochrane Library, up to May 5, 2017 without language restrictions. The primary outcomes in the present analysis were the rate of IUAs for prevention and the rate of IUA recurrence for treatment...
September 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28886702/safety-and-effectiveness-of-oral-misoprostol-for-induction-of-labour-in-a-resource-limited-setting-a-dose-escalation-study
#19
Marilyn Morris, John W Bolnga, Ovoi Verave, Jimmy Aipit, Allanie Rero, Moses Laman
BACKGROUND: Oral misoprostol as an induction of labour (IOL) agent is rapidly gaining popularity in resource-limited settings because it is cheap, stable at ambient temperatures, and logistically easier to administer compared to dinoprostone and oxytocin. We aim to investigate the safety and effectiveness of a regimen of oral misoprostol in Papua New Guinean women undergoing IOL. METHODS: As part of a prospective dose escalation study conducted at Modilon Hospital in Papua New Guinea, women with a singleton pregnancy in cephalic presentation and an unfavourable cervix who gave written informed consent were administered oral misoprostol, commencing at 25mcg once every 2 h for 4 doses and increased to 50mcg once every 2 h for 8 doses within 24 h...
September 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28864699/uterine-balloon-tamponade-as-an-adjunct-to-misoprostol-for-the-treatment-of-uncontrolled-postpartum-haemorrhage-a-randomised-controlled-trial-in-benin-and-mali
#20
Alexandre Dumont, Cécile Bodin, Benjamin Hounkpatin, Thomas Popowski, Mamadou Traoré, René Perrin, Patrick Rozenberg
OBJECTIVE: To assess the effectiveness of low-cost uterine tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage (PPH) in low-resource settings. DESIGN: Randomised controlled trial. SETTING: Seven healthcare facilities in Cotonou, Benin and Bamako, Mali. POPULATION: Women delivering vaginally who had clinically diagnosed PPH that was suspected to be due to uterine atony, who were unresponsive to oxytocin and who needed additional uterotonics...
September 1, 2017: BMJ Open
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