New Evidence on Buccal Misoprostol Expands Options for Medical Abortion
Gynuity Health Projects, in collaboration with seven clinical sites across the U.S., undertook a large randomized clinical trial to establish an evidence base for non-vaginal administration of misoprostol after mifepristone for medical abortion through the ninth week of pregnancy (63 days’ LMP). The study compared the efficacy, safety, and acceptability of two regimens: 200 mg mifepristone followed by (1) 800 mcg buccal or (2) 800 mcg oral misoprostol. While both regimens where shown to be safe, effective, and highly acceptable, the efficacy buccal misoprostol administration was superior to that of oral, especially among women with pregnancies 57-63 days’ LMP.
These results support more widespread use of buccal misoprostol administration in first trimester medical abortion. Based on these results, Planned Parenthood Federation of America’s National Medical Committee and the National Abortion Federation modified their respective clinical guidelines to incorporate use of buccal misoprostol 800 mcg following 200 mg mifepristone through 63 days’ LMP. Given the influence that PPFA and NAF’s policies have on those of other abortion providers, these changes likely will have significant and far-reaching effects on expanding women’s options for first trimester abortion.
The article reporting these results has generated substantial interest among the medical community since its publication in December’s issue of Obstetrics and Gynecology. It also has been rated as newsworthy and highly relevant for practice by an international panel of clinical research experts and an international group of practicing physicians collaborating with BMJ Group and McMaster University’s Health Information Research.