Medical methods for first trimester abortion.

@article{Kulier2011MedicalMF,
  title={Medical methods for first trimester abortion.},
  author={Regina Kulier and Nathalie Kapp and Ahmet Metin G{\"u}lmezoglu and George Justus Hofmeyr and Linan Cheng and Aldo Campana},
  journal={The Cochrane database of systematic reviews},
  year={2011},
  volume={11},
  pages={
          CD002855
        }
}
BACKGROUND Surgical abortion by vacuum aspiration or dilatation and curettage has been the method of choice for early pregnancy termination since the 1960s. Medical abortion became an alternative method of first trimester pregnancy termination with the availability of prostaglandins in the early 1970s and anti-progesterones in the 1980s. The most widely researched drugs are prostaglandins (PGs) alone, mifepristone alone, methotrexate alone, mifepristone with prostaglandins and methotrexate with… 
Medical methods for first trimester abortion.
TLDR
The effectiveness and side effects of different medical methods for first trimester abortion are compared to identify the best dosage, regimen, and route of administration to optimise patient outcomes.
Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: a systematic review
TLDR
Combined regimens using mifepristone and misoprostol had lower rates of ongoing pregnancy, higher rates of successful abortion and satisfaction compared to misOProstol only regimens and the rate of serious adverse events was generally low.
A review of evidence for safe abortion care.
Efficacy of combination of tablet mifepristone and misoprostol for first trimester pregnancy termination at different gestational age
TLDR
First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy.
Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses
TLDR
The published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration, and the quality of evidence was very low to moderate.
Analysis of Complications and Management After Self-Administration of Medical Termination of Pregnancy Pills
TLDR
The majority of the pregnant women who took MTP pills presented with serious complications in the form of bleeding, incomplete/missed abortion, and ectopic pregnancy, and restriction of the over-the-counter dispensation of abortion pills needs to be strictly implemented.
Pain during medical abortion, the impact of the regimen: A neglected issue? A review
TLDR
Standardised evaluation of pain is needed and the correlation between the dosage of misoprostol and the intensity of pain must be assessed in future studies.
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References

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Medical versus surgical methods for first trimester termination of pregnancy.
TLDR
There is inadequate evidence to comment on the acceptability and side effects of medical compared to surgical first-trimester abortions, and there is a need for trials to address the efficacy of currently used methods and women's preferences more reliably.
Options for early therapeutic abortion: a comparative review.
TLDR
The ability to compare medical and surgical methods is limited by the fact that there are few randomised studies and the definitions of successful outcome (complete abortion), adverse effects and complications vary from one study to the other.
Medical Abortion-An Alternative to Surgical Abortion.
A comparison of medical abortion (using mifepristone and gemeprost) with surgical vacuum aspiration: efficacy and early medical sequelae.
TLDR
Results were gestation-related; at 50 days of amenorrhoea there was little to choose between the two procedures and women who are unsure which method to use are likely to find vacuum aspiration more acceptable at longer gestations.
Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability.
TLDR
It is concluded that the addition of water onto misoprostol tablets does not improve its efficacy in first trimester medical abortion and is not recommended for medical abortion because of the high failure rate and low acceptability.
Methotrexate and misoprostol vs misoprostol alone for early abortion. A randomized controlled trial.
TLDR
Methotrexate and vaginal misoprostol are more effective than misop frostol alone and may offer an alternative to the use of antiprogestin and prostaglandin for medical abortion.
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