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Medical uses

Contraindications

risks/complications

Technique

There are three methods for medical abortion:


 * Mifepristone followed by misoprostol
 * The National Abortion Federation (NAF) recommends a mifepristone and misoprostol combination regimen, wherever mifepristone is legally available and accessible. This is an option for patients with gestations through 70 days. Mifepristone 200 mg is taken and followed by misoprostol 800 mcg buccally, vaginally, or sublingually 24 to 48 hours later. (add citation for the guidelines HERE) A 2011 systematic review found that it was simpler and equally safe to administer mifepristone in clinic and have the pregnant woman later take misoprostol at home as it was to administer both drugs in the clinic. (add citation HERE)
 * The World Health Organization recommends the combined use of mifeprostone followed by misoprostol for pregnancies of gestational age 9 weeks or less. This combination consists of 200mg mifeprostone followed by 800mcg of misoprostol to be taken within 24-48 hours. The misoprostol can be administered in the clinic or at home. For pregnancies that are 9-12 weeks of gestational age, the WHO recommends the initial 200mg mifeprostone dose to be followed by 800mcg misoprostol administered vaginally, which can be repeated every three hours up to 4 total doses. In this case, the misoprostol must be administered in the clinic. (keep same WHO citation as in original article)
 * Misoprostol alone
 * This is considered the second-line agent when mifepristone is not legally available or difficult to access. This is an appropriate option for gestations through 70 days. (put in citation for the national abortion federation guideline)
 * Methotrexate followed by misoprostol
 * Though not a first line choice, a methotrexate/misoprostol combination regimen is appropriate. Methotrexate is given either orally or intramuscularly, followed by vaginal misoprostol 3-5 days later. This is an appropriate option for gestations through 63 days. (need to look up if WHO discourages this regimen or not)

Medical abortion regimens using mifepristone in combination with a prostaglandin analog (such as misoprostol) are the most common methods used to induce second-trimester abortions in Canada, most of Europe, China and India; in contrast to the United States where 96% of second-trimester abortions are performed surgically by dilation and evacuation. The

Pharmacology

recovery/rehabilitation

History (e.g., when it was invented)

Society and culture (include legal issues, if any)

Special populations

Other animals - may not include this if not enough resources