Gynuity Health Projects

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Misoprostol added to the WHO Model List of Essential Medicines for the Treatment of PPH

This news section describes the addition of misoprostol for the treatment of postpartum hemorrhage (PPH) to the World Health Organization’s 19th Model List of Essential Medicines (EML) in 2015.

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List of Mifepristone Approvals

Gynuity Health Projects tracks the approval of mifepristone throughout the world. This list reflects our latest information about the registration of this medication. If you become aware of registration in new countries, please write to .(JavaScript must be enabled to view this email address) so we can update the list.

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List of Mifepristone Approvals

Gynuity Health Projects tracks the approval of mifepristone throughout the world. This list reflects our latest information about the registration of this medication. If you become aware of registration in new countries, please write to .(JavaScript must be enabled to view this email address) so we can update the list.

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List of Mifepristone Approvals

Gynuity Health Projects tracks the approval of mifepristone throughout the world. This list reflects our latest information about the registration of this medication. If you become aware of registration in new countries, please write to .(JavaScript must be enabled to view this email address) so we can update the list.

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A prospective open-label study of home use of mifepristone for medical abortion in Nepal

This study sought to assess the uptake and acceptability of at-home self-administration of mifepristone for medical abortion in Nepal. The majority of study participants chose to take the mifepristone at home; 98% of these women would recommend home administration to a friend undergoing medical abortion.

Int J Gynaecol Obstet. 2015 Mar;128(3):220-3.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/25482435.

Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City

This study assessed the efficacy and acceptability of extending outpatient medical abortion in Mexico City through 70 days’ LMP (one week beyond standard outpatient provision). The overall success rate was very high, and the difference in success between women in the 9th week of pregnancy and women in the 10th week was not statistically significant.

Reproductive Health Matters. 2015 Feb;22(44 Suppl 1):75-82.

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  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Sanhueza Smith, P., Peña, M., Dzuba, I.G., García Martinez, L.G., Aranguré Peraza, A.G., Bousiéguez, M., Shochet, T., Winikoff, B.
  • Published: February 2015

Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

This paper reports on a study that evaluated the feasibility and acceptability of telephone follow-up after medical abortion using an at-home semi-quantitative pregnancy test (SQPT) and checklist, and compared this mode of follow-up with traditional in-clinic assessment. The researchers found that this alternative method of follow-up was indeed feasible and highly effective in identifying ongoing pregnancy. Contraception. 2015 Feb;91(2):178-83

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The introduction of first trimester medical abortion in Armenia

A series of research activities were undertaken in Armenia to assess the introduction of medical abortion. A clinical study found medical abortion to be acceptable, feasible, and highly effective. Follow-up assessments found that all five of the study sites continued to offer medical abortion after the study was completed, with four of the sites achieving high success rates.

Reproductive Health Matters. 2015 Feb;22(44 Suppl 1):56-66.

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Self-Administration of Misoprostol for Prevention of Postpartum Hemorrhage (PPH)

This instructional pamphlet uses both pictures and text to explain the correct use of misoprostol for the prevention of PPH. It was developed as a tool that organizations or health facilities can use to educate providers, families, and women on how to use misoprostol for prevention of PPH.

The pictorial panels are targeted to illiterate and low-literate audience and the descriptive paragraphs serve to explain the pictures and provide supplementary information. The organization or health facility distributing the pamphlet may include their contact information in the space provided at the top of the sixth panel. (If this PDF is not compatible with your Internet browser and the filling of form fields is not supported, please click the button labeled “Open with different viewer.” This should be located in the right-hand corner of your screen.)

Folding instructions:

1. Fold pamphlet length-wise along the dotted-line in the middle of the paper so the pictures and text face out.

2. Then fold the 6 panels along the dotted vertical lines accordion-style, so all panels lay on top of each other with the title panel in the front and contact information in the back (see pdf link called instructions for additional information).

The "text only" version in this language is not currently available.

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Self-Administration of Misoprostol for Prevention of Postpartum Hemorrhage (PPH)

This instructional pamphlet uses both pictures and text to explain the correct use of misoprostol for the prevention of PPH. It was developed as a tool that organizations or health facilities can use to educate providers, families, and women on how to use misoprostol for prevention of PPH.

The pictorial panels are targeted to illiterate and low-literate audience and the descriptive paragraphs serve to explain the pictures and provide supplementary information. The organization or health facility distributing the pamphlet may include their contact information in the space provided at the top of the sixth panel. (If this PDF is not compatible with your Internet browser and the filling of form fields is not supported, please click the button labeled “Open with different viewer.” This should be located in the right-hand corner of your screen.)

Folding instructions:

1. Fold pamphlet length-wise along the dotted-line in the middle of the paper so the pictures and text face out.

2. Then fold the 6 panels along the dotted vertical lines accordion-style, so all panels lay on top of each other with the title panel in the front and contact information in the back (see pdf link called instructions for additional information).

The "text only" version in this language is not currently available.

Download PDF in English

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Other Languages Available

What happens when we routinely give doxycycline to medical abortion patients?

In some settings, antibiotics are routinely prescribed following medical abortion. This study compared side effects among women who received doxycycline to those who did not and evaluated adherence to one prescribed regimen. Adherence was found to be moderate; women who were prescribed doxycycline reported significantly more vomiting than their counterparts. Contraception. 2015 Jan;91(1):19-24.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/25444253.

Self-Administration of Misoprostol for Prevention of Postpartum Hemorrhage (PPH)

This instructional pamphlet uses both pictures and text to explain the correct use of misoprostol for the prevention of PPH. It was developed as a tool that organizations or health facilities can use to educate providers, families, and women on how to use misoprostol for prevention of PPH.

The pictorial panels are targeted to illiterate and low-literate audience and the descriptive paragraphs serve to explain the pictures and provide supplementary information. The organization or health facility distributing the pamphlet may include their contact information in the space provided at the top of the sixth panel. (If this PDF is not compatible with your Internet browser and the filling of form fields is not supported, please click the button labeled “Open with different viewer.” This should be located in the right-hand corner of your screen.)

Folding instructions:

1. Fold pamphlet length-wise along the dotted-line in the middle of the paper so the pictures and text face out.

2. Then fold the 6 panels along the dotted vertical lines accordion-style, so all panels lay on top of each other with the title panel in the front and contact information in the back (see pdf link called instructions for additional information).

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF version:

Download

Download eBook version:

EPUB format for iPad, Nook, and
Sony Reader.

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Knowledge of Abortion Laws and Services among Low-Income Women in Three United States Cities

This paper reports on a survey administered to low-income and minority women to assess their knowledge of abortion laws and services. First-generation immigrants and primarily Spanish speakers were less likely to have correct knowledge than higher-generation or primarily English speakers. More efforts are needed t about abortion, particularly among migrant women and non-primary English speakers.

J Immigrant Minority Health. 2014 Dec 9. [Epub ahead of print]

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/25488893.

Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy

This paper provides a broad overview of emergency contraception. Topics covered include specific methods and regimens, efficacy, side effects, mechanism of action, and population impacts.

Mortality of induced abortion, other outpatient surgical procedures, and common activities in the United States

In response to a multitude of new legislation in the U.S. regulating induced abortion in the guise of protecting women’s health, the authors compared abortion-related mortality to mortality associated with other outpatient surgical procedures as well as some nonmedical activities. Induced abortion in the U.S. is extremely safe and these efforts to regulate it only impede access and potentially harm women.

Contraception 2014 Nov;90(5):476-479.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/25152259.

Hormonal contraceptive methods and risk of HIV acquisition in women: a systematic review of epidemiological evidence

This systematic review commissioned by the WHO updates a review published in 2012 that assessed whether hormonal contraceptives affect the risk of HIV acquisition. As in the original review, the data do not suggest a link between the use of oral contraceptives and increased risk; however, the relationship between progestin-only injectable contraceptives and risk of HIV acquisition continues to be uncertain. Women using injectables should be educated regarding this uncertainty and empowered to use HIV preventative measures.

Contraception. 2014 Oct;90(4):360-90.

Access the full text at: http://www.contraceptionjournal.org/article/S0010-7824(14)00571-X/fulltext.

  • Topic: Contraception
  • Type: Staff Publication
  • Author: Polis, C.B., Phillips, S.J., Curtis, K.M., Westreich, D.J., Steyn, P.S., Raymond, E., Hannaford, P., Turner, A.N.
  • Published: October 2014

DMPA and HIV: do we need a trial?

The relationship between the use of progestin-only injectable contraceptives and the risk of HIV acquisition remains unclear. In this Editorial, the authors discuss the state of knowledge, current research, and the conflicting views of experts. One key issue is whether or not a trial- one designed specifically to examine this relationship- is warranted. The authors present the practical problems with undertaking such a study, and call for much greater discussion on the topic.

Access the full article at: http://www.contraceptionjournal.org/article/S0010-7824%2814%2900611-8/fulltext.

Claims of misoprostol use based on blood sampling should be viewed with skepticism

In this Special Communication, the authors warn against the validity of any claims regarding the existence of misoprostol in bodily fluids. Several women have recently been prosecuted for induced abortion based on allegations that they took misoprostol; however, these claims are dubious based on the timing required for accurate assessment as well as the arduous and costly procedures involved with lab testing to determine the presence of misoprostol. Therefore, a high level of scrutiny is needed to substantiate any such claims.

Int J Gynaecol Obstet. 2014 Aug 27. pii: S0020-7292(14)00432-9. doi: 10.1016/j.ijgo.2014.08.006. [Epub ahead of print]

Access the abstract.

Calibrated delivery drape versus indirect gravimetric technique for the measurement of blood loss after delivery: a randomized trial

This study compared measures of blood loss obtained from two different measurement techniques frequently used in studies focusing on the prevention and treatment of post-partum hemorrhage (PPH). Significantly greater mean blood loss was recorded by the direct than by the indirect measurement technique, suggesting a meaningful difference in blood loss measurement between these two methods.

BMC Pregnancy Childbirth. 2014 Aug 15;14(1):276. doi: 10.1186/1471-2393-14-276.

Access the article at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141098/.

First experience of the use of misoprostol as post-abortion care in Libreville, Gabon

The aim of this study was to assess the efficacy and acceptability of 400μg of sublingual misoprostol as first-line treatment of incomplete abortion in Gabon. The rate of successful uterine evacuation was very high (95.7%) as was satisfaction among participants (99.3% satisfied or very satisfied). The findings add to the evidence that this regimen can be successfully introduced in low resource settings.

Pan African Medical Journal 18, 301, 14/08/2014

Access the article at: http://www.panafrican-med-journal.com/content/article/18/301/full/.

Première expérience de l’utilisation du Misoprostol comme soin après avortement (SAA) à Libreville, Gabon.

The aim of this study was to assess the efficacy and acceptability of 400μg of sublingual misoprostol as first-line treatment of incomplete abortion in Gabon. The rate of successful uterine evacuation was very high (95.7%) as was satisfaction among participants (99.3% satisfied or very satisfied). The findings add to the evidence that this regimen can be successfully introduced in low resource settings.

Pan African Medical Journal 18, 301, 14/08/2014.

Link to full article: http://www.panafrican-med-journal.com/content/article/18/301/full/.

Commentary: Evidence versus influence in the WHO procedure for approving essential medicines: misoprostol for maternal health

This letter was written as a response to a commentary stating that misoprostol for PPH prevention was added to the Essential Medicine’s List (EML) not because of evidence supporting its use but because of “influence and vested interest”. Winikoff refutes this argument by citing evidence that supports misoprostol for this use, and by documenting the history of misoprostol advocacy and research that together provide a strong rationale for EML inclusion.

BMJ 2014;349:g4823.

Aceess the link at: http://www.bmj.com/content/349/bmj.g4823/rapid-responses.

Acceptability and feasibility of mifepristone medical abortion in the early first trimester in Azerbaijan

This study examined the acceptability and feasibility of introducing early medical abortion with mifepristone and misoprostol in Azerbaijan. All women were given the option of taking the misoprostol at home, and women in two of the three study sites were also given the option of taking the mifepristone at home. Efficacy and satisfaction were both very high, and a large proportion of women (74% of those eligible) chose home administration of both drugs.

The European Journal of Contraception and Reproductive Health Care, 2014; Early Online: 1–8.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/25047120.

Efficacy and acceptability of a mifepristone-misoprostol combined regimen for early induced abortion among women in Mexico City

This study aimed to evaluate the experiences of women seeking medical abortion at public sector facilities in a Mexico City district. The mifepristone-misoprostol regimen that was utilized was highly effective and acceptable among study participants.

Int J Gynaecol Obstet. 2014 Jun 4. pii: S0020-7292(14)00295-1. doi: 10.1016/j.ijgo.2014.04.012. [Epub ahead of print]

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/24957534.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Peña, M., Dzuba, I.G., Smith, P.S., Mendoza, L.J., Bousiéguez, M., Martínez, M.L., Polanco, R.R., Villalón, A.E., Winikoff, B.
  • Published: June 2014

Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

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Decentralizing postabortion care in Senegal with misoprostol for incomplete abortion

This study sought to increase access to post-abortion care (PAC) services at the community level in Senegal by introducing misoprostol as a first-line treatment. Both efficacy and satisfaction with the regimen were very high, demonstrating that this treatment can be successfully provided by lower level clinicians in community health settings.

Int J Gynaecol Obstet. 2014 May 15. pii: S0020-7292(14)00239-2. doi: 10.1016/j.ijgo.2014.03.028. [Epub ahead of print]

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/24893962.

Medical abortion work in Eastern Europe/Central Asia

This summary describes Gynuity’s body of work in Eastern Europe, the Caucasus, and Central Asia.

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Medical abortion work in Eastern Europe/Central Asia

This summary describes Gynuity’s body of work in Eastern Europe, the Caucasus, and Central Asia.

The "text only" version in this language is not currently available.

Download PDF in English

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Medical abortion work in Eastern Europe/Central Asia

This summary describes Gynuity’s body of work in Eastern Europe, the Caucasus, and Central Asia.

A "text only" version is available for users with slower internet connections.

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Download PDF version:

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RU OK? The acceptability and feasibility of remote technologies for follow-up after early medical abortion

This study evaluated the effectiveness and feasibility of using remote technology (text message, online, or phone questionnaire) in lieu of an in-clinic visit to increase the rate of follow-up after early medical abortion. The researchers found that follow-up via remote communication was feasible and preferable for most women.

Contraception. 2014 Apr 13. [Epub ahead of print] pii: S0010-7824(14)00149-8. doi: 10.1016/j.contraception.2014.03.016.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/24815098.

Acceptability and feasibility of medical abortion with mifepristone and misoprostol in Nigeria

This article reports on a study that sought to examine the acceptability and feasibility of medical abortion in Nigeria. High rates of efficacy and participant satisfaction suggest that this method could be successfully introduced for legal pregnancy termination throughout Nigeria and in other settings with limited access to legal abortion services.

International Journal of Gynecology and Obstetrics. 2014 Apr;125(1):49-52.

Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/24507887.

Buccal misoprostol for IUFD Research Group. Buccal misoprostol for treatment of fetal death at 14-28 weeks of pregnancy: a double-blind randomized controlled trial

This study sought to assess whether buccal misoprostol is effective for treating intrauterine fetal death. The authors found that a 200 mcg dose, repeated at 6-hour intervals, was more effective than a 100 mcg dose in evacuating the uterus within 48 hours. Contraception. 2014 Mar;89(3):187-92.

Access abstract at http://www.ncbi.nlm.nih.gov/pubmed/24405797.

  • Topic: Pregnancy Failure
  • Type: Staff Publication
  • Author: Bracken, H., Ngoc, N.T., Banks, E., Blumenthal, P.D., Derman, R.J., Patel, A., Gold, M., Winikoff, B
  • Published: March 2014

A single-arm study to evaluate the efficacy, safety and acceptability of pericoital oral contraception with levonorgestrel

This study sought to reevaluate the potential of pericoital levonorgestrel for pregnancy prevention. The study was stopped early due to low enrollment and feasibility concerns. The Pearl Index (22.4) was higher than expected; additional research could help identify whether the results were regimen or study related. Contraception. 2014 Mar;89(3):215-21.

Access the abstract of this article at http://www.contraceptionjournal.org/article/S0010-7824%2813%2900735-X/abstract.

  • Topic: Contraception
  • Type: Staff Publication
  • Author: Taylor, D.J., Lendvay, A., Halpern, V., Bahamondes, L.G., Fine, P.M., Ginde, S.Y., Wheeless, A., Raymond, E.G.
  • Published: March 2014

Providing Medical Abortion in Low-resource Settings: An Introductory Guidebook, 2nd Edition

This tool was developed for health care providers and policy makers who are interested in introduction of medical methods for safe termination of early pregnancy. It describes evidence-based regimens and practical considerations for introducing the method as part of abortion care, especially as related to low-resource settings.

The availability and use of medical abortion has increased rapidly since the publication of the first edition of this guidebook in 2004. We wrote the second edition of Providing Medical Abortion in Developing Countries: An Introductory Guidebook to incorporate important scientific developments and innovations in clinical practice. These changes have informed the emergence of protocols that can be used in a variety of low-resource settings worldwide. The new title Providing Medical Abortion in Low-Resource Settings reflects these broader applications. The guidebook follows the same chapter and topic sequence as the first edition. The second edition includes updated information on routes of misoprostol administration, infection and medical abortion, use of medical abortion for late first trimester abortion induction, telemedicine and medical abortion, professional and international clinical guidelines for use of mifepristone-misoprostol medical abortion, and a list of additional resources now available.

Please note that the 2nd edition of this resource in PDF was produced in Arabic, English, French, Indonesia, Portuguese, Russian, Spanish, Tamil, Turkish, and Vietnamese. The 1st edition of this resource is still available in Romanian from the drop-down menu.

We are also pleased to announce that this resource is now available to view in E-pub format in English from the drop-down menu.

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  • Topic: Medical Abortion
  • Type: Clinical Guidelines
  • Author: Abuabara, K., Blum, J. (eds. 1st edition), Bracken, H. (ed. 2nd edition), Gynuity Health Projects
  • Published: May 2004
  • Last Updated: December 2009

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WHO Multicountry Survey on Maternal and Newborn Health Research Network. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health

A secondary analysis of cross-sectional data was conducted to better understand clinical practice, risks, and maternal outcomes associated with postpartum hemorrhage (PPH). The analysis included approximately 275,000 women in 28 countries. The team concluded that even among health care facilities that report having the ability to provide all essential obstetric care, disparities remain in the incidence of severe outcomes among women with PPH.

BJOG. 2014 Mar;121 Suppl 1:5-13.
Access the abstract at: http://www.ncbi.nlm.nih.gov/pubmed/24641530.

FAQ on Misoprostol Detection in Blood

Recent efforts to prosecute women for induced abortion have included allegations that misoprostol was found in the woman’s blood. This document contains a few critical questions which may help to ascertain if such allegations could be real.

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FAQ on Misoprostol Detection in Blood

Recent efforts to prosecute women for induced abortion have included allegations that misoprostol was found in the woman’s blood. This document contains a few critical questions which may help to ascertain if such allegations could be real.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in português

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FAQ on Misoprostol Detection in Blood

Recent efforts to prosecute women for induced abortion have included allegations that misoprostol was found in the woman’s blood. This document contains a few critical questions which may help to ascertain if such allegations could be real.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

Download

Other Languages Available

FAQ on Misoprostol Detection in Blood

Recent efforts to prosecute women for induced abortion have included allegations that misoprostol was found in the woman’s blood. This document contains a few critical questions which may help to ascertain if such allegations could be real.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF version:

Download

Download eBook version:

EPUB format for iPad, Nook, and
Sony Reader.

Download

Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

The "text only" version in this language is not currently available.

Download PDF in português

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Mifepristone plus misoprostol or misoprostol-alone for treatment of intrauterine fetal death 12-24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for treatment of intrauterine fetal death 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone to induce fetal and placental expulsion with a demised fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

The "text only" version in this language is not currently available.

Download PDF in português

Download

Other Languages Available

Mifepristone plus misoprostol or misoprostol-alone for treatment of intrauterine fetal death 12-24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for treatment of intrauterine fetal death 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone to induce fetal and placental expulsion with a demised fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

Download

Other Languages Available

Mifepristone plus misoprostol or misoprostol-alone for treatment of intrauterine fetal death 12-24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for treatment of intrauterine fetal death 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone to induce fetal and placental expulsion with a demised fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in français

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Other Languages Available

Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in français

Download

Other Languages Available

Mifepristone plus misoprostol or misoprostol-alone for treatment of intrauterine fetal death 12-24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for treatment of intrauterine fetal death 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone to induce fetal and placental expulsion with a demised fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in English

Download

Other Languages Available

Mifepristone plus misoprostol or misoprostol-alone for treatment of intrauterine fetal death 12-24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for treatment of intrauterine fetal death 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone to induce fetal and placental expulsion with a demised fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF version:

Download

Download eBook version:

EPUB format for iPad, Nook, and
Sony Reader.

Download

Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

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Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

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Mifepristone plus misoprostol or misoprostol-alone for abortion induction in pregnancies 12 - 24 weeks’ LMP

Gynuity Health Projects convened an expert meeting in 2013 looking at the use of mifepristone and misoprostol for abortion induction in pregnancies 12-24 weeks’ LMP. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of mifepristone and misoprostol or misoprostol-alone for termination of pregnancies with a live fetus. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials.

A "text only" version is available for users with slower internet connections.

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Is One Of These Things Not Just Like The Other? Why Abortion can’t be Separated from Contraception

In this commentary, Dr. Winikoff discusses how family planning advocates have long worked to separate abortion from contraception in the minds of the public and legislature. She provides a history of the separation, and discusses how this strategy to keep contraception clear of the negative connotations associated with abortion has backfired.

Conscience. 2014;35(3):27-29.

Access the article at: http://digital.graphcompubs.com/publication/?i=226388&p=28.

Acceptability and feasibility of phone follow-up after early medical abortion in Vietnam: a randomized controlled trial

This study investigated the use of telephone follow-up combined with a semiquantitative urine pregnancy test and symptom checklist as a possible replacement for in-clinic follow-up after medical abortion. While telephone follow-up was very effective, the pregnancy test alone provided higher specificity in screening for ongoing pregnancy.

Obstet Gynecol. 2014 Jan;123(1):88-95.

Access the abstract of this article at: http://www.ncbi.nlm.nih.gov/pubmed/24463668.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Ngoc, N.T., Bracken, H., Blum, J., Nga, N.T., Minh, N.H., van Nhang, N., Lynd, K., Winikoff, B., Blumenthal, P.D.
  • Published: January 2014

A two-pill sublingual misoprostol outpatient regimen following mifepristone for medical abortion through 70 days' LMP: a prospective comparative open-label trial

This study examined the efficacy and acceptability of a medical abortion regimen using mifepristone and sublingual misoprostol, and compared the effectiveness at 64-70 days’ LMP to that at 57-63 days’ LMP. Neither the rates of success not the rates of ongoing pregnancy differed significantly between the two gestational age groups, suggesting that this regimen can be offered up to 70 days’ LMP.

Contraception. 2013 Nov 26. pii: S0010-7824(13)00736-1. doi: 10.1016/j.contraception.2013.11.014. [Epub ahead of print]

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Bracken, H., Dabash, R., Tsertsvadze, G., Posohova, S., Shah, M., Hajri, S., Mundle, S., Chelli, H., Zeramdini, D., Tsereteli, T., Platais, I., Winikoff, B.
  • Published: November 2013

Progestin-only pills for contraception

This review examined RTCs of progestin-only pills to assess differences in rates of efficacy, acceptability, and continuation. The authors found that there was insignificant evidence to compare these pills to each other or to compare them to combined oral contraceptives. Cochrane Database Syst Rev. 2013 Nov 13;11:CD007541. http://www.ncbi.nlm.nih.gov/pubmed/24226383

http://summaries.cochrane.org/CD007541/progestin-only-pills-for-contraception.

Repeat use of Emergency Contraception in Kenya: Letter to the editor

This letter responds to an article reporting on a published survey of women purchasing emergency contraception (EC) at pharmacies in Kenya. One of the key findings of the article is the high number of women who had already used EC that same month. This letter identifies a sampling bias in the methodology that led to an overestimation of this finding. A reanalyzation of the survey data is suggested. (no abstract available)

Letter to the editor on Emergency Contraception

This letter is a response to a published case report of an ectopic pregnancy following use of levonorgestrel emergency contraception (EC) wherein the authors argue that EC may increase the risk of ectopic pregnancy. This letter provides evidence that this is not the case, and asserts that use of EC may in fact lower the risk of ectopic pregnancy. (no abstract available)

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

The "text only" version in this language is not currently available.

Download PDF in português

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Other Languages Available

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

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Other Languages Available

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in Русский

Download

Other Languages Available

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in français

Download

Other Languages Available

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in English

Download

Other Languages Available

Abortion Induction with Misoprostol Alone in Pregnancies through 9 weeks' LMP

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting in 2003 looking at the use of misoprostol for abortion induction. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results were compiled in a brochure called “Instructions for Use – (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was reviewed in 2013 by an expert group convened by Gynuity Health Projects and updated with new information and research developments.

Please note that “Abortion Induction with Misoprostol Alone in Pregnancies through 9 Weeks’ LMP” has been updated in October 2013 in the following languages: English, French, Indonesian, Portuguese, Spanish and Russian .

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in Bahasa Indonesia

Download

Other Languages Available

Spermicide used alone for contraception

This review examined RCTs of spermicide used alone for contraception and presents efficacy findings for each study. Pregnancy rates varied considerably between trials; personal characteristics and behavior of users also impacted the probability of preventing pregnancy.

Cochrane Database Syst Rev. 2013 Sep 30;9: CD005218.

http://summaries.cochrane.org/CD005218/spermicide-used-alone-for-birth-control

  • Topic: Contraception
  • Type: Staff Publication
  • Author: Grimes, D.A., Lopez, L.M., Raymond, E.G., Halpern, V., Nanda, K., Schulz, K.F.
  • Published: September 2013

Misoprostol for Treatment of Incomplete Abortion: A Training Guide

This tool was developed for program planners and trainers of clinical providers who are interested in the introduction of misoprostol for incomplete abortion services. It describes evidence-based regimens and practical considerations for introducing the method as part of postabortion care services, especially as related to low-resource settings.

The training guide offers a range of ways to prepare health care providers to introduce the method, including detailed information on
• Efficacy, safety and acceptability;
• Eligibility criteria and precautions;
• Dosing, timing and routes of administration;
• Visit schedule and management of complications;
• Counseling and information provision;
• Integration of misoprostol into existing postabortion care (PAC) services

The guide includes a CD-ROM to guide delivery of didactic information, including a series of PowerPoint presentations. The slide sets can be found at the end of the PDFs.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

Download

Other Languages Available

Medical abortion: A path to safe, high-quality abortion care in Latin America and the Caribbean

Abortion rates in Latin America and the Caribbean (LAC) are very high and methods are often unsafe. This paper offers evidence that the use of medical abortion could reduce abortion-related morbidity and mortality, despite strict abortion laws. The authors address ways to improve medical abortion services and discuss the many remaining barriers to access in this region.

Access the full abstract at The European Journal of Contraception and Reproductive Health Care, (Sep 2013); Early Online: 1–10.

Embracing post-fertilisation methods of family planning: a call to action

In this commentary, the authors present an argument for developing a family planning method that could be used after fertilization. Such a method could be used later after sex than emergency contraceptives and could possibly be used only when a woman’s menstrual period is delayed. While there would likely be political fallout, a post-fertilization method would likely appeal to many women and thus efforts to produce such a method would be worthwhile.

Access the full abstract at J Fam Plann Reprod Health Care 2013 Oct;39(4):244-6. doi: 10.1136/jfprhc-2013-100702.

  • Topic: Contraception
  • Type: Staff Publication
  • Author: Raymond, E.G., Coeytaux, F., Gemzell-Danielsson, K., Moore, K., Trussell, J., Winikoff, B.
  • Published: August 2013

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

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Postpartum bleeding is reduced with sublingual powdered misoprostol when compared with oxytocin injection, but a new formulation of misoprostol is unlikely to revolutionise postpartum haemorrhage care.

This commentary responds to the findings of a study that compared powered sublingual misoprostol with oxytocin injection for prevention of postpartum haemorrhage. The study authors reported a lower rate of PPH with the misoprostol than with the oxytocin and called for research using sublingual misoprostol tablets. Winikoff and Durocher present contradictory evidence from a large body of literature and suggest that given the unusually high rate of PPH and bleeding with the oxytocin, the quality of the oxytocin may have been subpar. Of greater benefit would be to focus on integrating these two drugs (with already established formulations) as appropriate, particularly in low-resource settings.

Access the abstract of this article at Evid Based Med. 2013;18(4):143-4.

Acceptability of home use of mifepristone for medical abortion

This article reports on a study evaluating a medical abortion regimen that entails taking both mifepristone and misoprostol at the woman’s home. The results demonstrate a high acceptability of this option for both women and providers.

Access the abstract of this article at Contraception (Jul 2013). Vol 88(1):122-127.

Prophylactic compared with therapeutic Ibuprofen analgesia in first-trimester medical abortion: a randomized controlled trial

This article reports on a study that sought to compare the efficacy of two ibuprofen regimens (therapeutic vs. prophylactic) in first-trimester abortion. Women assigned to both groups reported high levels of pain. Prophylactic use of ibuprofen did not appear to lessen the length or severity of pain.

Obstet Gynecol. 2013 Sep;122(3):558-64. doi: 10.1097/AOG.0b013e31829d5a33.
Abstract available at: http://blog.psiimpact.com/2013/06/psi-honors-champions-in-womens-health-at-the-2013-impact-awards/.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Raymond, E.G., Weaver, M.A., Louie, K.S., Dean, G., Porsch, L., Lichtenberg, E.S., Ali, R., Arnesen, M.
  • Published: June 2013

Map of Mifepristone Approvals

Gynuity Health Projects tracks the approval of mifepristone throughout the world. This map reflects our latest information about the registration of this medication. If you become aware of registration in new countries, please write to .(JavaScript must be enabled to view this email address).

A "text only" version is available for users with slower internet connections.

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Map of Mifepristone Approvals

Gynuity Health Projects tracks the approval of mifepristone throughout the world. This map reflects our latest information about the registration of this medication. If you become aware of registration in new countries, please write to .(JavaScript must be enabled to view this email address).

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

Download

Other Languages Available

Dealing with Breast Cancer [letter]

In this Letter, the authors reply to an article that suggested the risk of breast cancer could be reduced by avoiding oral contraceptives. Drs. Raymond and Grossman argue that while the relationship between breast cancer and oral contraceptives is ambiguous, there is strong evidence that the pill lessens the risk of ovarian, uterine, and probably colorectal cancers.

New York Times, June 4, 2013.

Acceptability and Feasibility of Mifepristone-Misoprostol For Menstrual Regulation in Bangladesh

Using pills instead of vacuum aspiration for menstrual regulation could increase access to services and reduce high levels of related morbidity in Bangladesh. This study investigated the efficacy and acceptability (to both women and providers) of using a mifepristone-misoprostol regimen for menstrual regulation. Findings include high levels of success and patient satisfaction. Providers became more comfortable with the method after gaining experience.

International Perspectives on Sexual and Reproductive Health (June 2013). Vol 39 (2):79-87.

Access the full article at www.guttmacher.org/pubs/journals/3907913.pdf.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Alam, A., Bracken, H., Johnston, H. B., Raghavan, S., Islam, N., Winikoff, B., Reichenbach, L.
  • Published: June 2013

Social marketing of emergency contraception: Are we missing a valuable opportunity?

This editorial explores provision of emergency contraceptive pills (ECPs) by international social marketing organizations. The authors conducted a survey of 4 large social marketing organizations and found that only one third of their family planning programs include provision of ECPs. The authors identify several key barriers to increased EC provision and discuss possible strategies to address them.

Contraception 2013;87(6):703-705. (no abstract)

Results from a study using misoprostol for management of incomplete abortion in Vietnamese hospitals

This study investigated the use of 400 mcg sublingual misoprostol for uterine evacuation following incomplete abortion. In addition to evaluating efficacy and acceptability, the study sought to demonstrate the applicability of this method in lower level settings. Findings include high rates of success and satisfaction and suggest a clear path for task shifting post-abortion care from physicians to lower- or midlevel providers.

BMC Pregnancy Childbirth. 2013 May 22;13:118. doi: 10.1186/1471-2393-13-118.

Full article available at http://www.biomedcentral.com/content/pdf/1471-2393-13-118.pdf.

Simplified medical abortion using a semi-quantitative pregnancy test for home-based follow-up

Medical abortion follow-up typically includes a return visit to the clinic, adding to both the cost and time required of women and providers. This study examined the efficacy and ease of use of a semi-quantitative pregnancy test (SQPT) used at home to identify ongoing pregnancy following medical abortion. All ongoing pregnancies were successfully identified by the SQPT, and most women found the test easy to use.

Access the full abstract at International Journal of Gynecology & Obstetrics. 2013;121(2):144-148.

Cost-effectiveness of increased access to emergency contraceptive pills: probably not.

This Letter to the Editor provides a response to a recent article in which the authors argued that increased use of emergency contraceptive pills (ECPs) would be cost effective due to the subsequent reduction in unintended pregnancies. Raymond et al. provide evidence to the contrary: that extensive research in this area has yet to produce any real evidence of such an effect.

Contraception. 2013;87(4):504. (no abstract)

Efficacy and acceptability of early mifepristone-misoprostol medical abortion in Ukraine: Results of two clinical trials

This paper reports on two studies that were conducted to improve service delivery of medical abortion in Ukraine by introducing updated, evidence-based regimens. Both studies demonstrated high efficacy and acceptability, as well as a preference for home administration of the misoprostol. The Ukraine Ministry of Health has since updated the national medical abortion protocol to reflect these findings.

Access the full abstract at The European Journal of Contraception and Reproductive Health Care. 2013 Apr;18(2):112-9.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Raghavan, S., Maistruk, G., Shochet, T., Bannikov, V., Posohova, S., Zhuk, S., Lishchuk, V., Winikoff, B.
  • Published: April 2013

Use of 400 μg of sublingual misoprostol after mifepristone for medical abortion up to 63 days since the last menstrual period: Evidence from Uzbekistan.

This study sought to assess the feasibility and acceptability of introducing medical abortion up to 63 days’ LMP in Uzbekistan, with the option of home administration of misoprostol. Findings include a high success rate and high acceptability among participants. In addition, almost all women chose to administer the misoprostol at home.

Access the full abstract at The European Journal of Contraception and Reproductive Health Care. 2013 Apr;18(2):104-11.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Raghavan, S., Tsereteli, T., Kamilov, A., Kurbanbekova, D., Yusupov, D., Kasimova, F., Jymagylova, D., Winikoff, B.
  • Published: April 2013

Misoprostol for Treatment of Incomplete Abortion: A Training Guide

This tool was developed for program planners and trainers of clinical providers who are interested in the introduction of misoprostol for incomplete abortion services. It describes evidence-based regimens and practical considerations for introducing the method as part of postabortion care services, especially as related to low-resource settings.

The training guide offers a range of ways to prepare health care providers to introduce the method, including detailed information on
• Efficacy, safety and acceptability;
• Eligibility criteria and precautions;
• Dosing, timing and routes of administration;
• Visit schedule and management of complications;
• Counseling and information provision;
• Integration of misoprostol into existing postabortion care (PAC) services

The guide includes a CD-ROM to guide delivery of didactic information, including a series of PowerPoint presentations. The slide sets can be found at the end of the PDFs.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in français

Download

Other Languages Available

Postpartum hemorrhage: Moving from Research to Reality

Gynuity and partners have been working since 2004 on a program of research with support from the Bill & Melinda Gates Foundation to help establish the safety, efficacy, and appropriateness of misoprostol for prevention and treatment of postpartum hemorrhage (PPH) in a variety of clinical settings. In 2009, in collaboration with partners, Gynuity embarked on a follow-up initiative to answer remaining research questions, address operational and service-delivery issues related to misoprostol’s applications including at the community-level, and influence policies and clinical practice guidelines to better reflect the evidence and promote appropriate use. This project description provides results of the initiative to date and planned activities under the new grant.

The "text only" version in this language is not currently available.

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Estimating contraceptive efficacy: the case of spermicides

The contraceptive efficacy of certain contraceptives, including vaginal spermicides, can be difficult to assess. This paper presents and evaluates available data on spermicides and discusses their implications. In addition, the authors call for further discussion of how to satisfactorily evaluate methods such as this that are only moderately effective in preventing pregnancy.

Contraception (Feb 2013) Vol. 87, Issue 2, Pages 134-137. (no abstract)

First-trimester medical abortion with mifepristone 200 mg and misoprostol: A systematic review

The dose of mifepristone approved by most government agencies for medical abortion is 600 mg. The aim of this review was to summarize extant data on the effectiveness and safety of regimens using the widely recommended lower mifepristone dose, 200 mg, followed by misoprostol in early pregnancy and to explore potential correlates of abortion failure.

Read the full abstract at Contraception (Jan 2013) Vol. 87(1):26-37.

Armenia: A Way to Make Abortion Safer. EurasiaNet commentary.

Abortion services are widely available in Armenia. However, riskier surgical methods- often with outdated approaches- are much more readily available than are medical regimens. This commentary reviews abortion provision in Armenia, describes the noted preference for home administration of medical methods by Armenian women, and calls for greater provider training in evidence-based medical abortion methods.

Published online 1/9/13 Eurasianet.org.

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

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Download PDF in Русский

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Other Languages Available

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in français

Download

Other Languages Available

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in español

Download

Other Languages Available

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF in English

Download

Other Languages Available

Institutional brochure

This brochure summarizes Gynuity’s program areas, key activities and partners.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF version:

Download

Download eBook version:

EPUB format for iPad, Nook, and
Sony Reader.

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Can at-home semi-quantitative pregnancy tests serve as a replacement for clinical follow-up of medical abortion? A US study.

Medical abortion in the United States requires clinic-based follow-up, representing additional time and cost to women and clinics. This study evaluated a semi-quantitative home pregnancy test as a possible replacement for in-person follow-up. The results demonstrate that at-home follow-up with a semi-quantitative pregnancy test is feasible for service delivery in the United States. Read the full abstract here Contraception (Dec 2012); Vol. 86(6):757-762.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Blum, J., Shochet, T., Lynd, K., Lichtenberg, S., Fischer, D., Arnesen, M., Winikoff, B., Blumenthal, P.D.
  • Published: December 2012

Sublingual Misoprostol for the Treatment of Postpartum Hemorrhage

This chapter, published in A Comprehensive Textbook of Postpartum Hemorrhage: An Essential Clinical Reference for Effective Management. 2nd Edition. Sapiens Publishing, 2012, describes the evidence to date for the use of sublingual misoprostol for the treatment of postpartum hemorrhage. The full chapter can be downloaded from the menu, and the entire textbook is available at the Global Library of Women’s Medicine.

The "text only" version in this language is not currently available.

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Other Languages Available

Extending outpatient medical abortion services through 70 days of gestational age

This article reports on a study evaluating a medical abortion regimen in an outpatient setting through 70 days gestational age. The results demonstrate the efficacy, acceptability and feasibility of the evaluated regimen in the context of outpatient services. Read the full abstract at Obstetrics and Gynecology (Nov 2012). Vol. 120 (5):1070-76.

  • Topic: Medical Abortion
  • Type: Staff Publication
  • Author: Winikoff, B., Dzuba, I.G., Chong, E., Goldberg, A.B., Lichtenberg, E.S., Ball, C., Dean, G., Sacks, D., Crowden, W.A., Swica, Y.
  • Published: November 2012

Sublingual misoprostol versus standard surgical care for treatment of incomplete abortion in five sub-Saharan African countries

This article reports data from multi-site randomized trials comparing 400 mcg misoprostol to standard surgical care for treatment of incomplete abortion in 5 sub-Saharan African countries: Burkina Faso, Mauritania, Niger, Nigeria and Senegal. The results provide additional evidence for the misoprostol regimen evaluated and demonstrate the feasibility of its use in this context. Download the PDF here BMC Pregnancy and Childbirth (Nov 2012). Vol 12:127.

Treatment approaches for preeclampsia in low-resource settings: A randomized trial of the Springfusor pump for delivery of magnesium sulfate

This article reports on the results of a trial evaluating the delivery of magnesium sulfate by a mechanical pump for treatment of preeclampsia. The authors conclude that the SpringFusor pump may offer an alternative to intramuscular administration of magnesium sulfate where electronic pumps are not available. The full article can be downloaded from the drop-down menu or read at Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012):32–38.

The "text only" version in this language is not currently available.

  • Topic: Pre-eclampsia
  • Type: Staff Publication
  • Author: Mundle, S., Regi, A., Easterling, T., Biswas, B., Bracken, H., Khedekare, V., Shekhavat, D.R., Durocher, J., Winikoff, B.
  • Published: October 2011

Download PDF in English

Download

Other Languages Available

Misoprostol for Treatment of Incomplete Abortion: A Training Guide

This tool was developed for program planners and trainers of clinical providers who are interested in the introduction of misoprostol for incomplete abortion services. It describes evidence-based regimens and practical considerations for introducing the method as part of postabortion care services, especially as related to low-resource settings.

The training guide offers a range of ways to prepare health care providers to introduce the method, including detailed information on
• Efficacy, safety and acceptability;
• Eligibility criteria and precautions;
• Dosing, timing and routes of administration;
• Visit schedule and management of complications;
• Counseling and information provision;
• Integration of misoprostol into existing postabortion care (PAC) services

The guide includes a CD-ROM to guide delivery of didactic information, including a series of PowerPoint presentations. The slide sets can be found at the end of the PDFs.

A "text only" version is available for users with slower internet connections.

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Misoprostol for Treatment of Incomplete Abortion: A Training Guide

This tool was developed for program planners and trainers of clinical providers who are interested in the introduction of misoprostol for incomplete abortion services. It describes evidence-based regimens and practical considerations for introducing the method as part of postabortion care services, especially as related to low-resource settings.

The training guide offers a range of ways to prepare health care providers to introduce the method, including detailed information on
• Efficacy, safety and acceptability;
• Eligibility criteria and precautions;
• Dosing, timing and routes of administration;
• Visit schedule and management of complications;
• Counseling and information provision;
• Integration of misoprostol into existing postabortion care (PAC) services

The guide includes a CD-ROM to guide delivery of didactic information, including a series of PowerPoint presentations. The slide sets can be found at the end of the PDFs.

A "text only" version is available for users with slower internet connections.

Open Text Version in New Window

Download PDF version:

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Download eBook version:

EPUB format for iPad, Nook, and
Sony Reader.

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Sublingual Misoprostol for the Treatment of Postpartum Hemorrhage

This chapter, published in A Comprehensive Textbook of Postpartum Hemorrhage: An Essential Clinical Reference for Effective Management. 2nd Edition. Sapiens Publishing, 2012, describes the evidence to date for the use of sublingual misoprostol for the treatment of postpartum hemorrhage. The full chapter can be downloaded from the menu, and the entire textbook is available at the Global Library of Women’s Medicine.

A "text only" version is available for users with slower internet connections (Only available in English at this time)

Open Text Version in New Window

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(Only English available at this time)

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Oral misoprostol as first-line care for incomplete abortion in Burkina Faso

This study aimed to explore 400 mcg sublingual misoprostol as primary treatment in lower-level facilities with no previous experience providing postabortion care. The results demonstrated that misoprostol is a viable option for treatment of incomplete abortion at mid-level facilities. Access the full article here International Journal of Gynecology and Obstetrics (2012), V119:166-169 or download from menu.

The "text only" version in this language is not currently available.

  • Topic: Pregnancy Failure
  • Type: Staff Publication
  • Author: Blandine, T., Ouattara, A.Z., Coral, A., Hassane, C., Clotaire, H., Dao, B., Lankoande, J., Diop, A., Blum, J.
  • Published: October 2012

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Use of Medicines Changing the Face of Abortion

This commentary discusses the important advance in modern abortion care that is the use of medications for pregnancy termination. The authors provide examples of its use in both legal and restrictive settings, private and public sectors, and by women themselves. Read the full article here International Perspectives on Sexual and Reproductive Health (2012), Vol 38(3):164-66 or download from the menu.

The "text only" version in this language is not currently available.

Download PDF in English

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Other Languages Available

Misoprostol for the management of postpartum bleeding: A new approach

This Special Communication discusses some of the benefits and limitations of current community approaches using misoprostol for postpartum hemorrhage prevention and presents a new hybrid model of “secondary prevention”—presumptive treatment for women with more than average blood loss—as one alternative community-based approach. Read the full abstract here International Journal of Gynecology and Obstetrics (Dec 2012) Vol 119(3):210-12.