Medication Abortion Before Confirmed Intrauterine Pregnancy Noninferior
WEDNESDAY, Nov. 6, 2024 -- For complete abortion, medication abortion before confirmed intrauterine pregnancy is noninferior to standard, delayed treatment, according to a study published in the Nov. 7 issue of the New England Journal of Medicine.
Karin Brandell, M.D., from the Karolinska Institutet in Stockholm, and colleagues conducted a multicenter, noninferiority, randomized controlled trial involving women requesting medication abortion at up to 42 days of gestation with an unconfirmed intrauterine pregnancy on ultrasound examination. Participants were randomly assigned to immediate start of abortion (early-start group; 754 participants) or standard-care treatment delayed until intrauterine pregnancy was confirmed (standard-care group; 750 participants). For the absolute between-group difference, the noninferiority margin was set at 3.0 percentage points.
The researchers found that a complete abortion occurred in 95.2 and 95.3 percent of participants in the early-start and standard groups, respectively (absolute between-group difference, −0.1 percentage points). Ectopic pregnancies occurred in 1.3 and 0.8 percent of participants in the early-start and standard-care groups, respectively. Serious adverse events occurred in 1.6 and 0.7 percent of participants in the early-start and standard groups, respectively, most of which were uncomplicated hospitalizations for ectopic pregnancy or incomplete abortion.
"We found that early start of medication abortion before confirmed intrauterine pregnancy was noninferior to delayed treatment after confirmed intrauterine pregnancy with respect to completing abortion," the authors write.
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