2003, Number s1
<< Back Next >>
Gac Med Mex 2003; 139 (s1)
Medical Abortion: Current Therapeutic Alternatives
Schiavon R
Language: Spanish
References: 57
Page: 55-64
PDF size: 125.07 Kb.
ABSTRACT
In this review, we describe the most relevant aspects of the different pharmacologic alternatives for interruption of pregnancy, including their mechanisms of action, efficacy, potential side effects, complications, and medical contraindications, with special emphasis on indications and regimens of misoprostol. Advantages and disadvantages of medical methods, their acceptability among patients and health care providers, as well as their potential role in management of abortion, particularly in developing countries, are also discussed.
REFERENCES
Creinin M. Medical abortion regimens: hospital context and overview. Am J Obstet Gynecol 2000;183:S3-S9.
National Abortion Federation. Early options: a provider’s guide to medical abortion. Washington, D.C., USA: National Abortion Federation;2001.
Tang OS, Ho PC. Medical abortion in the second trimester. Best Pract Res Clin Obstet Gynaecol 2002;16:237-246.
Tang OS, Thong KJ, Baird DT. Second trimester medical abortion with mifepristone and gemeprost: a review of 956 cases. Contraception 2001;64:29-32.
Schiavon R, Jiménez-Villanueva CH, Ellertson C, Langer A. Emergency contraception: a simple, safe, effective and economical method for preventing undesired pregnancy. Rev Invest Clin 2000;52:168-176.
Winikoff B, Ellertson C, Clark S. Analysis of failure in medical abortion. Contraception 1996;54:323-327.
Baird D. Mode of action of medical methods of abortion. JAMA 2000;55:121-126.
Physician’s desk reference. Montvale, NJ,USA: Thomson Medical Economics;1999.
ACOG practice bulletin. Medical management of tubal pregnancy. Number 3, December 1998. Clinical management guidelines for obstetrician-gynecologists. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 1999;65:97-103.
Creinin M, Darney P. Methotrexate and misoprostol for early abortion. Contraception 1993;48:339-348.
Creinin M. Medical abortion regimens: historical context and overview. Am J Obstet Gynecol 2000;183:S3-S9.
Creinin M, Aubény E. Medical abortion in early pregnancy. In: Paul M, Lichtenberg E, Borgatta L, Grimes D, Stubblefield P, (editors.). A clinician’s guide to medical and surgical abortion. New York: Churchill Livingstone; 1999.
Kruse B, Poppema S, Creinin M, Paul M. Management of side effects and complications in medical abortion. Am J Obstet Gynecol 2000;183: S65-S75.
Goldberg A, Greenberg M, Darney P. Misoprostol and pregnancy. N Engl J Med 2001;344:38-47.
Newhall E, Winikoff B. Abortion with mifepristone and misoprostol: regimens, efficacy, acceptability and future directions. Am J Obstet Gynecol 2000;183:S44-S53.
Schaff E, Fielding S. A comparison of the Abortion Rights Mobilization and Population Council trials. JAMA 2000;55:137-141.
Carbonell J, Varela L, Velazco L, Cabezas E, Fernández C, Sánchez C. Oral methotrexate and vaginal misoprostol for early abortion. Contraception 1998;57:83-88.
Creinin M. Randomized comparison of efficacy, acceptability and cost of medical versus surgical abortion. Contraception 2000;62:117-124.
Khan J, Becker B, MacIsaac L, Amory J, Neuhaus J, Olkin I, Creinin M. The efficacy of medical abortion: a meta-analysis. Contraception 2000;61:29-40.
Hausknecht R. Methotrexate and misoprostol to terminate early pregnancy. N Engl J Med 1995;333:537-540.
Creinin M, Vittinghoff E, Schaff E, Klaisle C, Darney P, Dean C. Medical abortion with oral methotrexate and vaginal misoprostol. Obstet Gynecol 1997;90:611-616.
Wiebe E, Dunn S, Guilbert E, Jacto F, Lugtig L. Comparisons of abortions induced by metotrexate or mifepristone followed by misoprostol. Obstet Gynecol 2002;99:813-819.
Costa S, Vessey MP. Misoprostol and illegal abortion in Rio de Janeiro. Lancet 1993;341:1258-1261.
Coelho HLL, Tei Xeira AC, Santos AP, et al. Misoprostol and illegal abortion in Fortaleza, Brazil. Lancet 1993;341:1261-1263.
Carbonell JLL, Varela L, Velazco A, Fernández C, Sánchez C. The use of misoprostol for abortion at <9 weeks’ gestation. Eur J Contracept Reprod Health Care 1997;2:181-185.
Carbonell JLL, Varela L, Velazco A, Tanda R, Cabeza E, Sánchez C. Early abortion with 800 g of misoprostol by the vaginal route. Contraception 1999;59:219-225.
Carbonell JLL, Rodríguez J, Aragón S, Velazco A, Tanda R, Sánchez C, Barambio S, Chami S, Valero F. Vaginal misoprostol 1000 g for early abortion. Contraception 2001;63:131-136.
Blanchard K, Winikoff B, Ellertson C. Misoprostol used alone for the termination of early pregnancy: a review of evidence. Contraception 1999;59:209-217.
Koopersmith TB, Mishell DR Jr. The use of misoprostol for termination of early pregnancy. Contraception 1996;53:243-246.
Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral and vaginal administration. Obstet Gynecol 1997;90:88-92.
Oi Shan Tang, Horts Schweer, HW Seyberth, Sharon WH Lee, Pak Chung HO. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod 2002;17:332-336.
Carbonell J, Varela L, Velazco A, Fernández C. The use of misoprostol for termination of early pregnancy. Contraception 1997;55:165-168.
Gonzalez CH, Vargas FR, Pérez AB, Kim CA, Brunoni D, Marques-Dias MJ, Leone CR, Correa Neto J, Llerena JC Jr, de Almeida JC. Limb deficiency with or without Mobius sequence in seven Brazilian children associated with misoprostol use in the first trimester of pregnancy. Am J Med Genet 1993;1;47:59-64.
Baker A, Beresford T, Halvorson-Boyd G, Garrity J. Informed consent, counseling and patient preparation. In: Paul M, Lichtenberg E, Borgatta L, Grimes D, Stubblefield P, editors. A clinician’s guide to medical and surgical abortion. New York: Churchill Livingstone;1999.
Reproductive Health Program. Mifeprex medical abortion: patient information and consent. Rochester, NY, USA: University of Rochester School of Medicine;2000.
Fielding SL, Schaff EA, Nam NY. Clinicians’ perception of sonogram indication for mifepristone abortion up to 63 days. Contraception 2002;66:27-31.
Walker K, Schaff E, Fielding S, Fuller L. Monitoring serum chorionic gonadotropin levels after mifepristone abortion. Contraception 2001;64:271-273.
Paul M, Schaff E, Nichols M. The roles of clinical assessment, human chorionic gonadotropin assays, and ultrasonography in medical abortion practice. Am J Obstet Gynecol. 2000;183 (Suppl):S34-S43.
Creinin M, Pymar H. Medical abortion alternatives to mifepristona. JAMA 2000;55:127-132.
National Abortion Federation. Early options training and resource binder: a provider’s guide to medical abortion. Washington, D.C., National Abortion Federation;2001.
Creinin MD, Shulman T. Effect of nonsteroideal anti-inflammatory drugs on the action of misoprostol in a regimen for early abortion. Contraception 1997;56:165-168.
Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, Du MK, Krishna UR, Eschen A, Ellertson C. Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus surgical abortion. Am J Obstet Gynecol 1997;176:431-437.
Wiebe E. Pain control in medical abortion. Int J Gynaecol Obstet. 2001;74:275-280.
MacIsaac L, Darney P. Early surgical abortion: an alternative to and back-up for medical abortion. Am J Obstet Gynecol 2000;183:S76-S83.
Isaacs JJr, McGehee R, Cowan B. Life-threatening neutropenia following treatment of ectopic pregnancy: a report of two cases. Obstet Gynecol 1996;88: 694-696.
Trout S, Kemmann E. Reversible alopecia after single-dose methotrexate treatment in a patient with ectopic pregnancy. Fertil Steril 1995;64:866-867.
Horrigan T, Fanning J, Marcotte M. Methotrexate pneumonitis after systemic treatment for ectopic pregnancy. Am J Obstet Gynecol 1997;176:714-715.
Creinin MD, Krohn MA. Methotrexate pharmacokinetics in women receiving methotrexate and misoprostol for early abortion. Am J Obstet Gynecol 1997;177:1444-1449.
Breitbart V. Counseling for medical abortion. Am J Obstet Gynecol 2000;183(2):S26-S33.
Winikoff B, Ellertson C. Elul B, Sivin I. Acceptability and feasibility of early pregnancy termination by mifepristone-misoprostol. Arch Fam Med 1998;7:360-366.
Schaff E, Eisinger S, Stadalius L, Franks P, Gore B, Poppema S. Low-dose mifepristone 200 mg and vaginal misoprostol for induced abortion Contraception 1999;59:1-6.
Elul B, Pearlman E, Sorhaindo A, Simonds W, Westhoff C. (2000). In depth interviews with medical abortion clients: thoughts on the method and home administration of misoprostol. JAMA 2000:55;169-172.
Clark S, Ellertson C, Winikoff B. Is medical abortion acceptable to all American women: the impact of socidemographic characteristics on the acceptability of mifepristone-misoprostol abortion. JAMA 2000;:5;177-188.
Coyaji K, Elul B, Krishna U, Otiv S, Ambardekar S, Bopardikar A, Raote V, Ellertson C, Winikoff B. Mifepristone-misoprostol abortion: a trial in rural and urban Maharashtra, India. Contraception 2002:66;33-40.
Joffe C. Medical abortion and the potential for new abortion providers: a cautionary tale. JAMA 2000;55(3 Suppl):151-154.
Koenig JD, Tapias MP, Hoff T, Stewart FH. Are US health professionals likely to prescribe mifepristone or methotrexate? J Am Med Womens Assoc 2000;55(3 Suppl):155-160.
Harvey SM, Beckman LJ, Satre SJ. Experiences and satisfaction with providing methotrexate-induced abortions among US providers. J Am Med Womens Assoc 2000;55(Suppl):161-163.