The most effective regimen for medication management of early pregnancy loss is mifepristone, 200 mg orally, followed 24 to 48 hours later by misoprostol, 800 mcg vaginally when available, the combination should be recommended over misoprostol alone. 9 – 11Ĭonsistent results from two prospective case series and a retrospective review Menstrual dating or ultrasonography is required to confirm gestational age prior to medication abortion ultrasonography should be performed in patients at risk of ectopic pregnancy or if gestational age cannot be confirmed using clinical data alone. 4Ĭonsensus guideline on the safety and quality of abortion care by the National Academies of Sciences, Engineering, and Medicine Mifepristone (Mifeprex) and misoprostol (Cytotec) can be safely prescribed by primary care clinicians in the outpatient setting. Clinical history, combined with serial quantitative beta human chorionic gonadotropin levels, urine pregnancy testing, or ultrasonography, is used to establish complete passage of the pregnancy tissue. Ongoing pregnancy, infection, hemorrhage, undiagnosed ectopic pregnancy, and the need for unplanned uterine aspiration are rare complications. The adverse effects of misoprostol (e.g., low-grade fever, gastrointestinal symptoms) can be managed with nonsteroidal anti-inflammatory drugs or antiemetics. Cramping and bleeding are expected effects of the medications, with bleeding lasting an average of nine to 16 days. The most effective regimens for medication management of early pregnancy loss and medication abortion include 200 mg of oral mifepristone (a progesterone receptor antagonist) followed by 800 mcg of misoprostol (a prostaglandin E 1analogue) administered buccally or vaginally. Ultrasonography is needed when gestational dating cannot be confirmed using clinical data alone or when there are risk factors for ectopic pregnancy. Gestational age is determined using ultrasonography or menstrual history. Medication regimens using mifepristone and misoprostol are safe and effective for outpatient treatment of early pregnancy loss for up to 84 days' gestation and for medication abortion up to 77 days' gestation.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |