Gynuity Health Projects

Gynuity is pleased to announce the publication of our new resource for clinicians and women’s health advocates: Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook. Misoprostol has many advantages in low-resource settings – it is inexpensive, widely available, thermostable, and offers a low-tech, non-invasive method of uterine evacuation. Based on current scientific evidence, the guidebook offers detailed information about misoprostol for this indication including:

• 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 PAC services.

In April, 2009, the World Health Organization announced the addition of misoprostol to its Model List of Essential Medicines based on its proven safety and efficacy for the treatment of incomplete abortion and miscarriage. The recommendation was made by an expert committee that evaluated available evidence, including numerous randomized comparative clinical trials and several guidelines developed by professional associations for this indication.

Gynuity is pleased to announce the publication of our new resource for clinicians and women’s health advocates: Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook. Misoprostol has many advantages in low-resource settings – it is inexpensive, widely available, thermostable, and offers a low-tech, non-invasive method of uterine evacuation. Based on current scientific evidence, the guidebook offers detailed information about misoprostol for this indication including:

• 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 PAC services.

In April, 2009, the World Health Organization announced the addition of misoprostol to its Model List of Essential Medicines based on its proven safety and efficacy for the treatment of incomplete abortion and miscarriage. The recommendation was made by an expert committee that evaluated available evidence, including numerous randomized comparative clinical trials and several guidelines developed by professional associations for this indication.

This annotated bibliography provides basic information about the studies that were used to create the regimen outlined in the brochure Instructions for Use: Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP. It was updated in July, 2008, to include additional relevant publications.

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 at this time, only the English language version of the 2nd edition is available for download. Other language versions are forthcoming; the first edition of this resource is still available in 8 languages from the drop-down menu.

This document summarizes select articles on different aspects of mifepristone medical abortion provision such as efficacy, safety, and acceptability of regimens used for first and second trimester pregnancies.

This document summarizes select articles on different aspects of mifepristone medical abortion provision such as efficacy, safety, and acceptability of regimens used for first and second trimester pregnancies.

This article reports on a study designed to evaluate the efficacy and acceptability of home administration of misoprostol for early medical abortion in Indian family planning clinics. Home administration of misoprostol was found to be safe and feasible for introduction into medical abortion services in India. Access the full abstract at International Journal of Gynaecology and Obstetrics, (Nov 2009) [Epub ahead of print].

Gynuity is pleased to announce the publication of our new resource for clinicians and women’s health advocates: Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook. Misoprostol has many advantages in low-resource settings – it is inexpensive, widely available, thermostable, and offers a low-tech, non-invasive method of uterine evacuation. Based on current scientific evidence, the guidebook offers detailed information about misoprostol for this indication including:

• 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 PAC services.

In April, 2009, the World Health Organization announced the addition of misoprostol to its Model List of Essential Medicines based on its proven safety and efficacy for the treatment of incomplete abortion and miscarriage. The recommendation was made by an expert committee that evaluated available evidence, including numerous randomized comparative clinical trials and several guidelines developed by professional associations for this indication.

Gynuity is pleased to announce the publication of our new resource for clinicians and women’s health advocates: Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook. Misoprostol has many advantages in low-resource settings – it is inexpensive, widely available, thermostable, and offers a low-tech, non-invasive method of uterine evacuation. Based on current scientific evidence, the guidebook offers detailed information about misoprostol for this indication including:

• 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 PAC services.

In April, 2009, the World Health Organization announced the addition of misoprostol to its Model List of Essential Medicines based on its proven safety and efficacy for the treatment of incomplete abortion and miscarriage. The recommendation was made by an expert committee that evaluated available evidence, including numerous randomized comparative clinical trials and several guidelines developed by professional associations for this indication.

This research summary describes the results of a series of clinical trials conducted by Gynuity and international colleagues on the use of misoprostol for the treatment of postpartum hemorrhage. The findings show:

• Sublingual misoprostol (800 mcg) is a safe, effective and acceptable alternative first-line treatment for PPH due to uterine atony.
• Misoprostol is easy to administer and may be particularly useful in settings where administration of IV oxytocin is not possible, particularly at lower levels of the health care system.
• Simultaneous administration of misoprostol (600 mcg) to conventional uterotonics for PPH treatment confers no clinical advantage.

Results of two of the trials described in this summary were published in The Lancet, Volume 375, Issue 9710, Pages 210 – 216, and Volume 375, Issue 9710, Pages 217 – 223.

This research summary describes the results of a series of clinical trials conducted by Gynuity and international colleagues on the use of misoprostol for the treatment of postpartum hemorrhage. The findings show:

• Sublingual misoprostol (800 mcg) is a safe, effective and acceptable alternative first-line treatment for PPH due to uterine atony.
• Misoprostol is easy to administer and may be particularly useful in settings where administration of IV oxytocin is not possible, particularly at lower levels of the health care system.
• Simultaneous administration of misoprostol (600 mcg) to conventional uterotonics for PPH treatment confers no clinical advantage.

Results of two of the trials described in this summary were published in The Lancet, Volume 375, Issue 9710, Pages 210 – 216, and Volume 375, Issue 9710, Pages 217 – 223.

This research summary describes the results of a series of clinical trials conducted by Gynuity and international colleagues on the use of misoprostol for the treatment of postpartum hemorrhage. The findings show:

• Sublingual misoprostol (800 mcg) is a safe, effective and acceptable alternative first-line treatment for PPH due to uterine atony.
• Misoprostol is easy to administer and may be particularly useful in settings where administration of IV oxytocin is not possible, particularly at lower levels of the health care system.
• Simultaneous administration of misoprostol (600 mcg) to conventional uterotonics for PPH treatment confers no clinical advantage.

Results of two of the trials described in this summary were published in The Lancet, Volume 375, Issue 9710, Pages 210 – 216, and Volume 375, Issue 9710, Pages 217 – 223.

This research summary describes the results of a study on the use of misoprostol for the prevention of postpartum hemorrhage conducted in Pakistan.

This research summary describes the results of a study on the use of misoprostol for the prevention of postpartum hemorrhage conducted in Pakistan.

This research summary describes the results of a study on the use of misoprostol for the prevention of postpartum hemorrhage conducted in Pakistan.

This study assessed the relationship between the false positive rapid plasma reagin test and several established clinical and biological markers for thrombophilia and/or autoimmune disease. Access the full abstract at American Journal of Reproductive Immunology (New York, N.Y. : 1989). 01/09/2009; 62(2):73-7.

Gynuity is pleased to announce the publication of our new resource for clinicians and women’s health advocates: Misoprostol for Treatment of Incomplete Abortion: An Introductory Guidebook. Misoprostol has many advantages in low-resource settings – it is inexpensive, widely available, thermostable, and offers a low-tech, non-invasive method of uterine evacuation. Based on current scientific evidence, the guidebook offers detailed information about misoprostol for this indication including:

• 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 PAC services.

In April, 2009, the World Health Organization announced the addition of misoprostol to its Model List of Essential Medicines based on its proven safety and efficacy for the treatment of incomplete abortion and miscarriage. The recommendation was made by an expert committee that evaluated available evidence, including numerous randomized comparative clinical trials and several guidelines developed by professional associations for this indication.

This article reports on a study conducted in Nepal with women undergoing medical abortions for gestations through 56 days’ LMP using a regimen of mifepristone followed by misoprostol. Read the full abstract at International Journal of Gynaecology and Obstetetrics 2009 Jul;106(1):39-42. Epub 2009 Apr 5.

This article addresses the safety and efficacy of first trimester abortion methods used in the United States. The author urges health care providers to ensure that all women are aware of and offered the full range of options. The article can be requested by contacting Journal Watch and referencing the full citation Journal Watch Women’s Health, (Jul 2009) Vol. 14(7);51-52.

This article reports results of a study designed to assess knowledge and attitudes towards abortion among women and obstetricians/ gynaecologists in Armenia, in order to facilitate the introduction of medical abortion. View the full abstract at European Journal of Contraception and Reproductive Health Care, (Jul 2009) 25:1-9. [Epub ahead of print].

This article reports on results of a clinical trial evaluating two routes of misoprostol administration following mifepristone for early medical abortion. For gestations through 56 days since last menstrual period 400mcg of oral misoprostol performed better than a 400mcg sublingual dose when following 200mg mifepristone although not significantly so. Access the full abstract at European Society of Contraception and Reproductive Health, (Jun 2009) Vol. 14(3);169-75.

This study, conducted in four clinical sites in Ankara, Turkey, evaluated the efficacy and acceptability of two misoprostol regimens (400 mcg oral or sublingual) following mifepristone for medical abortion for gestations 56 days’ LMP. The results demonstrate the feasibility of integrating medical abortion into health services in Turkey and the potential to increase choices for women. Access the full abstract of this article at European Society of Contraception and Reproductive Health Care, (Jun 2009) Vol. 14(3);169-75.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

This study compared misoprostol 600 mcg oral vs. 400 mcg sublingual for the treatment of incomplete abortion. The study was conducted with local colleagues in Madagascar and Moldova. Efficacy rates were 94.6% and 94.5%, for the oral and sublingual routes, respectively.

Access the full abstract at the following link Contraception 79; pp. 456–462.

In this article the role of mid-level health care providers in the provision of first trimester medical abortion care is discussed. The authors emphasize that non-physician providers such as nurses and midwives are well-positioned to offer services and that doing so could greatly expand access to medical abortion for women, especially in rural or remote areas. Access the full abstract at Reproductive Health Matters, 17(33);61-9.

This summary describes Gynuity’s body of work in the area of pregnancy failure and miscarriage.

This research summary describes the results of a study on the use of misoprostol for the prevention of postpartum hemorrhage conducted in Pakistan.

This research summary describes the occurrence of fever after administration of misoprostol for treatment of primary postpartum hemorrhage. The data were collected as part of a multi-country research initiative.

Unsafe abortion is one of the most neglected public health challenges in the Middle East and North Africa (MENA) region, where an estimated one in four pregnancies are unintended—wanting to have a child later or wanting no more children. Many women with unintended pregnancies resort to clandestine abortions that are not safe. This policy brief explores the public health concerns surrounding abortion in MENA and discusses ways to make it both rarer and safer.

Gynuity Health Projects tracks the approval of misoprostol 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 .

Gynuity Health Projects tracks the approval of misoprostol 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 .

This study compares a dose of 400mcg misoprostol taken sublingually or orally 24 hours after mifepristone administration for medical abortion in pregnancies through 63 days’ gestation. The study was conducted with local colleagues in Chisinau, Moldova. The sublingual route was found to be superior to the oral route (98.7% vs. 94%).

Access the full abstract at the following link Contraception (Feb 2009) 79(2);pp. 84-90.

This research summary describes the results of a knowledge, attitudes and practices survey on abortion and medical abortion conducted with medical providers and women in three urban areas of Armenia in June and July 2007.

This research summary describes the results of a knowledge, attitudes and practices survey on abortion and medical abortion conducted with medical providers and women in three urban areas of Armenia in June and July 2007.

This research summary describes the results of a knowledge, attitudes and practices survey on abortion and medical abortion conducted with medical providers and women in three urban areas of Armenia in June and July 2007.

This summary describes Gynuity’s body of work in the area of pre-eclampsia.

This summary describes Gynuity’s body of work in the area of medical abortion.

This summary describes Gynuity’s efforts in training and education to a range of audiences on issues related to reproductive and maternal health.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found 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 updated in June, 2008 based on new information and research developments.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found 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 updated in June, 2008 based on new information and research developments.

In June 2004, Gynuity convened a small group of international experts in the field of medical abortion and women’s health for a symposium held in Edinburgh, Scotland. Participants discussed current activities around novel abortifacient development and debated how best to balance resources between this research and efforts to improve existing medical abortion regimens. Participants included basic science researchers, social scientists, clinicians, and pharmaceutical industry experts. Much of the meeting focused on promising avenues of research and drug candidates in the areas of antiprogestins, other antihormones, prostaglandins and analogues, antifolates and antimetabolites, and angiogenesis inhibitor drugs (currently being developed as cancer therapies). More broadly, participants explored the qualities of an “ideal” abortifacient, as well as the social and political considerations involved in developing and promoting new therapies. Among the priority areas identified for future collaborative work were: 1) continuing to introduce medical abortion in countries where it is currently unavailable; 2) determining the lowest effective dose of misoprostol and developing single-dose regimens for mifepristone-misoprostol medical abortion; 3) establishing the minimum technology required for medical abortion; and 4) improving medical abortion for gestations >9 weeks.

This paper presents findings from a study undertaken in 2003 in one district in Rajasthan to analyse the content of information materials on abortion and sex determination and people’s perceptions of them.

Access the full abstract of this article at the following link Reproductive Health Matters (May 2006), 14(27), pp160-171.

This article reports on a study designed to evaluate the efficacy, safety, and acceptability of oral immediately swallowed and buccal misoprostol 800 mcg after mifepristone 200 mg for terminating pregnancy through 63 days since the last menstrual period (LMP). The results demonstrate that buccal misoprostol 800 mcg after mifepristone 200 mg is a good option for medical abortion through 63 days since the LMP. Oral misoprostol 800 mcg is also a safe and effective alternative, although success rates diminish with increasing gestational age.

Access the full abstract for this article at Obstetrics & Gynecology (Dec 2008);112:1303-1310.

The region of Latin America and the Caribbean (LAC) has one of the highest rates of maternal mortality due to unsafe abortion in the world, accounting for 17% of total regional maternal deaths (WHO, 2004). The consequences of abortion-related mortality and morbidity motivate health and development organizations to invest attention and resources in this devastating public health issue. This working paper touches on some of the issues involved in developing a strategy to introduce medical abortion technology into reproductive health services in Brazil, Colombia, Mexico and Peru. These are among the most populous countries in the region (PAHO, 2006) and they report some of the highest rates of morbidity and mortality related to unsafe abortion. The paper summarizes information about medical abortion regimens, describes the context and availability of medical abortion drugs in each country, and discusses specific issues relevant to the introduction of medical abortion regimens.

The region of Latin America and the Caribbean (LAC) has one of the highest rates of maternal mortality due to unsafe abortion in the world, accounting for 17% of total regional maternal deaths (WHO, 2004). The consequences of abortion-related mortality and morbidity motivate health and development organizations to invest attention and resources in this devastating public health issue. This working paper touches on some of the issues involved in developing a strategy to introduce medical abortion technology into reproductive health services in Brazil, Colombia, Mexico and Peru. These are among the most populous countries in the region (PAHO, 2006) and they report some of the highest rates of morbidity and mortality related to unsafe abortion. The paper summarizes information about medical abortion regimens, describes the context and availability of medical abortion drugs in each country, and discusses specific issues relevant to the introduction of medical abortion regimens.

This research summary describes the results of a knowledge, attitudes and practices survey on abortion and medical abortion conducted with medical providers and women in three urban areas of Armenia in June and July 2007.

This list describes clinical research conducted by Gynuity Health Projects in collaboration with local colleagues. It also notes the specific countries in which each protocol has been or is currently being implemented.

This summary describes Gynuity’s work in the area of policy and advocacy related to a range of reproductive and maternal health issues in the U.S. and internationally.

Unsafe abortion is one of the most neglected public health challenges in the Middle East and North Africa (MENA) region, where an estimated one in four pregnancies are unintended—wanting to have a child later or wanting no more children. Many women with unintended pregnancies resort to clandestine abortions that are not safe. This policy brief explores the public health concerns surrounding abortion in MENA and discusses ways to make it both rarer and safer.

This research summary reports on data collected through a series of large-scale trials conducted by Gynuity and colleagues to evaluate the effectiveness of misoprostol for postpartum hemorrhage. As part of this study, blood loss after vaginal delivery was collected and measured systematically for over 39,000 deliveries. The summary describes the objective measurement techniques used and key outcomes.

This research summary describes the occurrence of fever after administration of misoprostol for treatment of primary postpartum hemorrhage. The data were collected as part of a multi-country research initiative.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

This summary describes Gynuity’s work in the area of social science research on a range of reproductive and maternal health issues.

This summary describes Gynuity’s efforts to provide technical assistance on a range of reproductive and maternal health issues to national and international organizations.

This summary describes Gynuity’s efforts in training and education to a range of audiences on issues related to reproductive and maternal health.

This summary describes Gynuity’s work in the area of STIs, HIV and infectious disease.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found 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 updated in June, 2008 based on new information and research developments.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

This research summary reports on data collected through a series of large-scale trials conducted by Gynuity and colleagues to evaluate the effectiveness of misoprostol for postpartum hemorrhage. As part of this study, blood loss after vaginal delivery was collected and measured systematically for over 39,000 deliveries. The summary describes the objective measurement techniques used and key outcomes.

This research summary describes the occurrence of fever after administration of misoprostol for treatment of primary postpartum hemorrhage. The data were collected as part of a multi-country research initiative.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found 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 updated in June, 2008 based on new information and research developments.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

This research summary reports on data collected through a series of large-scale trials conducted by Gynuity and colleagues to evaluate the effectiveness of misoprostol for postpartum hemorrhage. As part of this study, blood loss after vaginal delivery was collected and measured systematically for over 39,000 deliveries. The summary describes the objective measurement techniques used and key outcomes.

This summary describes Gynuity’s work in the area of social science research on a range of reproductive and maternal health issues.

This summary describes Gynuity’s body of work in the area of pregnancy failure and miscarriage.

This summary describes Gynuity’s body of work in the area of pre-eclampsia.

This research summary describes the occurrence of fever after administration of misoprostol for treatment of primary postpartum hemorrhage. The data were collected as part of a multi-country research initiative.

This summary describes Gynuity’s efforts to provide technical assistance on a range of reproductive and maternal health issues to national and international organizations.

This summary describes Gynuity’s efforts in training and education to a range of audiences on issues related to reproductive and maternal health.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

This research summary reports on data collected through a series of large-scale trials conducted by Gynuity and colleagues to evaluate the effectiveness of misoprostol for postpartum hemorrhage. As part of this study, blood loss after vaginal delivery was collected and measured systematically for over 39,000 deliveries. The summary describes the objective measurement techniques used and key outcomes.

This reference list forms the basis for the regimen outlined in the brochure Instructions for Use (IFU): Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP.

This summary describes Gynuity’s body of work in the area of pregnancy failure and miscarriage.

This research summary describes the occurrence of fever after administration of misoprostol for treatment of primary postpartum hemorrhage. The data were collected as part of a multi-country research initiative.

This reference list forms the basis for the regimen outlined in the brochure Instructions for Use (IFU): Misoprostol for Treatment of Incomplete Abortion and Miscarriage.

This summary describes Gynuity’s work in the area of STIs, HIV and infectious disease.

This summary describes Gynuity’s work in the area of STIs, HIV and infectious disease.

Unsafe abortion is one of the most neglected public health challenges in the Middle East and North Africa (MENA) region, where an estimated one in four pregnancies are unintended—wanting to have a child later or wanting no more children. Many women with unintended pregnancies resort to clandestine abortions that are not safe. This policy brief explores the public health concerns surrounding abortion in MENA and discusses ways to make it both rarer and safer.

The third in a series, this Instructions for Use (IFU) brochure on the use of misoprostol for prevention of postpartum hemorrhage was drafted based on current available information. In June 2007, Gynuity invited professionals with epidemiological, clinical and programmatic expertise on PPH prevention and misoprostol to review this document. The aim of this collaborative review was to reach consensus on clinical practice guidelines and make available evidence-based information on appropriate use of misoprostol for this indication. This brochure will be updated as new information and research developments become available.

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 at this time, only the English language version of the 2nd edition is available for download. Other language versions are forthcoming; the first edition of this resource is still available in 8 languages from the drop-down menu.

Postpartum hemorrhage (PPH) remains a major killer of women worldwide. Standard uterotonic treatments used to control postpartum bleeding do not always work and are not always available. Misoprostol’s potential as a treatment option for PPH is increasingly known, but its use remains ad hoc and available evidence does not support the safety or efficacy of one particular regimen. This study aimed to determine the adjunct benefit of misoprostol when combined with standard oxytocics for PPH treatment. The study concluded that a 600 mcg dose of misoprostol given sublingually shows promise as an adjunct treatment for PPH and its use should continue to be explored for its life-saving potential in the care of women experiencing PPH.

See the full text of this article at BMC Pregnancy and Childbirth (Aug 2008), 8(1):40.

Gynuity and colleagues compiled a series of Frequently Asked Questions (FAQs) and their answers aimed at giving medical abortion providers and women’s health advocates the language to discuss the occurrence of severe infections caused by Clostridium sordellii following mifepristone-misoprostol medical abortion so they are able to present the science in an informed and responsible manner.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting 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 will be periodically reviewed and updated with new information and research developments.

Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found 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 updated in June, 2008 based on new information and research developments.

The meeting summarized in this report was organized in 2001 because up until that point a large body of scientific work supporting the use of misoprostol for a range of reproductive and maternal health indications had not been synthesized in an accessible way. As a result, there had been no consensus on the use of misoprostol for women’s health and no strategic agenda for continuing development of the technology. Meeting participants agreed that a major priority for research and policy is creation of a solid clinical science base for all women’s health problems for which misoprostol is effective. Providers must be trained, guidelines created and women educated so that the use of the drug is safe and effective. Finally, a broader policy strategy is necessary to support program development in identified priority areas.

This issue of Outlook Newsletter, produced by Path with Gynuity Health Projects invited as Guest Editor, focuses on the potential relationship between hormonal contraceptive use and HIV transmission.

This summary explores the complex question of whether using hormonal contraceptives could affect a woman’s risk of being infected with HIV or developing AIDS.

In May, 2005 Gynuity held a meeting on the relationship of hormonal contraceptive use to HIV transmission and disease progression. The meeting examined the most up-to-date evidence on the topic, needs and strategies for future research, and what actions family planning and HIV prevention programs should currently be taking in response to what is known. This fact sheet addresses some of the most frequently asked questions on this topic.

In May, 2005, Gynuity held a meeting on the relationship of hormonal contraceptive use to HIV transmission and disease progression. The meeting examined the most up-to-date evidence on the topic, needs and strategies for future research, and what actions family planning and HIV prevention programs should currently be taking in response to what is known.

PAC in Action is a newsletter of the Postabortion Care Consortium. Gynuity Health Projects was invited as a guest editor on this special issue devoted to misoprostol for postabortion care. The newsletter also includes an annotated bibliography developed by Gynuity that summarizes over two dozen articles reporting on misoprostol use for this indication.

PAC in Action is a newsletter of the Postabortion Care Consortium. Gynuity Health Projects was invited as a guest editor on this special issue devoted to misoprostol for postabortion care. The newsletter also includes an annotated bibliography developed by Gynuity that summarizes over two dozen articles reporting on misoprostol use for this indication.

PAC in Action is a newsletter of the Postabortion Care Consortium. Gynuity Health Projects was invited as a guest editor on this special issue devoted to misoprostol for postabortion care. The newsletter also includes an annotated bibliography developed by Gynuity that summarizes over two dozen articles reporting on misoprostol use for this indication.

In October, 2003, a group of researchers, policy makers, and program developers came together to explore the use of misoprostol for Post Abortion Care (PAC). The goals of the meeting were to exchange information about misoprostol for PAC and discuss strategies for bringing misoprostol into current PAC protocols. The meeting included a roundtable discussion on the obstacles affecting access to misoprostol and concluded with a discussion of plans for the future. The report offers highlights from the presentations, and a summary of the plan for moving forward with this promising technology.