Comparative analysis of the clinical effectiveness and safety of modern methods of early artificial abortions. Cohort study results
DOI:
https://doi.org/10.15574/HW.2024.172.29Keywords:
artificial abortion, complications, pregnancy, womenAbstract
WHO experts have determined that medical abortion and vacuum aspiration are currently safe methods of terminating an unintended pregnancy in the first trimester.
Aim - to conduct a comparative analysis of the clinical effectiveness and safety of modern methods of early artificial abortions.
Materials and methods. An analysis of early and late complications of early abortion was carried out in 54 women with medical abortion using mifepristone and misoprostol (group I) and 65 respondents after abortion by vacuum aspiration (group II). Statistical data processing was carried out using the SPSS 21 program.
Results. The frequency of fetal egg retention, pregnancy progression, abnormal uterine bleeding, and endometrial polyps was significantly higher after medical abortion, and endometritis - after vacuum aspiration. Women who underwent medical abortion compared to termination of pregnancy by vacuum aspiration have a 2.3 and 3.6 times lower risk of placental complications and the threat of termination of future pregnancy (odds ratio (OR): 0.28; 95% confidence interval (95% CI): 0.12-0.64 and OR: 0.24; 95% CI: 0.06-0.88), as well as cesarean delivery (OR: 0.34; 95% CI: 0.14-0.84).
Conclusions. The effectiveness of the medical method of early termination of pregnancy was 90.7%, vacuum aspiration - 98.5%, which is a relatively safe alternative to surgical abortion.
This study did not involve any experiments on animals or humans.
No conflict of interests was declared by the authors.
References
Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C et al. (2020). Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health. 8(9): e1152-e1161. https://doi.org/10.1016/S2214-109X(20)30315-6; PMid:32710833
Elul В, Ellertson С, Winikoff В, Coyaji K. (2019). Side effects of mifepristone-misoprostol abortion versus surgical abortion. Data from a trial in China, Cuba and India. Contracept. 59(2): 107-114. https://doi.org/10.1016/S0010-7824(99)00003-7; PMid:10361625
Gatter M, Cleland K, Nucatola DL. (2015). Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days. Contraception. 91(4): 269-273. https://doi.org/10.1016/j.contraception.2015.01.005; PMid:25592080 PMCid:PMC4373977
Huang Y, Zhang X, Li W, Song F, Dai H, Wang J et al. (2014). A meta-analysis of the association between induced abortion and breast cancer risk among Chinese females. Cancer Causes Control. 25(2): 227-236. https://doi.org/10.1007/s10552-013-0325-7; PMid:24272196
Ireland LD, Gatter M, Chen AY. (2015). Medical Compared With Surgical Abortion for Effective Pregnancy Termination in the First Trimester. Obstet Gynecol. 126(1): 22-28. https://doi.org/10.1097/AOG.0000000000000910; PMid:26241252
Jackson JE, Grobman WA, Haney E, Casele H. (2007). Mid-trimester dilation and evacuation with laminaria does not increase the risk for severe subsequent pregnancy complications. Int J Gynaecol Obstet. 96(1): 12-15. https://doi.org/10.1016/j.ijgo.2006.08.011; PMid:17196205
Kaminskyy V, Pryadko N, Bulgakova V. (2015). Osoblyvosti vedennia medykamentoznoho abortu. Zdorovia zhinky. 6(102): 32-34.
Kerns J, Steinauer J. (2013). Management of postabortion hemorrhage: release date November 2012 SFP Guideline #20131. Contraception. 87(3): 331-342. https://doi.org/10.1016/j.contraception.2012.10.024; PMid:23218863
Liu N, Ray JG. (2023). Short-Term Adverse Outcomes After Mifepristone-Misoprostol Versus Procedural Induced Abortion: A Population-Based Propensity-Weighted Study. Ann Intern Med. 176(2): 145-153. https://doi.org/10.7326/M22-2568; PMid:36592459
Männistö J, Mentula M, Bloigu A, Hemminki E, Gissler M, Heikinheimo O, Niinimäki M. (2013). Medical versus surgical termination of pregnancy in primigravid women - is the next delivery differently at risk? A population-based register study. BJOG. 120(3): 331-337. https://doi.org/10.1111/1471-0528.12034; PMid:23126244
Michels KB, Xue F, Colditz GA, Willett WC. (2007). Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study. Arch Intern Med. 167(8): 814-820. https://doi.org/10.1001/archinte.167.8.814; PMid:17452545
Ngo TD, Park MH, Free C. (2013). Safety and effectiveness of termination services performed by doctors versus midlevel providers: a systematic review and analysis. Int J Womens Health. 5: 9-17. https://doi.org/10.2147/IJWH.S39627; PMid:23323024 PMCid:PMC3541713
Romanenko TG, Morozova OV.(2022). A modern view on the termination of an unwanted pregnancy by a non-surgical method. Reproductive Health of Woman. 1: 8-12. https://doi.org/10.30841/2708-8731.1.2022.258129
Romero M, Gomez Ponce de Leon R, Baccaro LF, Carroli B, Mehrtash H, Randolino J et al. (2021). Abortion-related morbidity in six Latin American and Caribbean countries: findings of the WHO/HRP multi-country survey on abortion (MCS-A). BMJ Glob Health. 6(8): e005618. https://doi.org/10.1136/bmjgh-2021-005618; PMid:34417270 PMCid:PMC8404437
Saccone G, Perriera L, Berghella V. (2016). Prior uterine evacuation of pregnancy as independent risk factor for preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol. 214 (5): 572-591. https://doi.org/10.1016/j.ajog.2015.12.044; PMid:26743506
Upadhyay UD, Desai S, Zlidar V, Weitz TA, Grossman D, Anderson P, Taylor D. (2015). Incidence of emergency department visits and complications after abortion. Obstet Gynecol. 125(1): 175-183. https://doi.org/10.1097/AOG.0000000000000603; PMid:25560122
Virk J, Zhang J, Olsen J. (2021). Medically-induced abortion and risk of reproductive failures in subsequent pregnancy. Ugeskr Laeger. 179: 4363-4365.
Vovk IB, Tymchenko OI, Revenko OO, Revenko OM. (2014). Abort - predyktor porushen reproduktyvnoho zdorovia zhinky. Zdorovia Ukrainy. Tematychnyi nomer. Berezen: 44-47.
Wiegerinck MM, Jones HE, O'Connell K, Lichtenberg ES, Paul M, Westhoff CL. (2008). Medical abortion practices: a survey of National Abortion Federation members in the United States. Contraception. 78 (6): 486-491. https://doi.org/10.1016/j.contraception.2008.07.015; PMid:19014795
World Health Organization. (2022). Abortion care guideline [Internet]. Geneva: World Health Organization.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
