Medical abortion in the second trimester - an update.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
01 12 2023
01 12 2023
Historique:
medline:
3
11
2023
pubmed:
24
10
2023
entrez:
24
10
2023
Statut:
ppublish
Résumé
The safety and efficacy of medical abortion in the second trimester is provider independent and may therefore offer advantages over surgical second trimester abortion in certain settings. Due to bleeding risk, medical abortions in the second trimester are still mostly performed in a clinic or hospital setting. The most effective regimen for abortion includes pretreatment with oral mifepristone and following doses of misoprostol. An alternative is misoprostol only which should only be used when mifepristone is not available. The optimal dosing of prostaglandin to achieve the highest efficacy with the lowest proportion of complications remains to be established. Complications are rare and serious adverse events uncommon but may include uterine rupture especially in women with a previous cesarean delivery or uterine surgery. Women having second trimester medical abortion are a diverse group with different indications for the abortion. All women should be offered pain relief and respectful care. Staff involved in second trimester medical abortion often find their work challenging. At the same time, staff indicate pride and a conviction of contributing to the 'greater good' for women and society. Staff involved in second trimester abortion should be offered guidance and support through the employer. Post abortion contraception should be offered to all women having second trimester medical abortions, including those who have the abortion due to fetal malformation. All methods of contraception can be started immediately after a second trimester medical abortion except for cycle based methods and diaphragms.
Identifiants
pubmed: 37873766
doi: 10.1097/GCO.0000000000000913
pii: 00001703-990000000-00098
doi:
Substances chimiques
Misoprostol
0E43V0BB57
Mifepristone
320T6RNW1F
Prostaglandins
0
Abortifacient Agents, Nonsteroidal
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
490-495Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
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