A recent study published in the New England Journal of Medicine indicates that medication abortions are safe and effective even when administered very early in pregnancy, before ultrasound confirmation. This finding challenges the common practice of delaying such procedures until pregnancy is confirmed via ultrasound, typically around weeks five to six.
The study, conducted across 26 clinics in nine countries, involved over 1,500 women who requested an abortion before ultrasound could confirm their pregnancy. Participants were randomly assigned to either receive an early medication abortion or have their abortion delayed until ultrasound confirmation.
Comparable Success Rates
The results showed that both groups had high success rates, with over 95% of women experiencing a complete and successful abortion. Specifically, in the delayed treatment group, 4.5% of medication abortions failed and required additional surgery, while in the early group, 3% of pregnancies continued, and 1.8% required surgery for an incomplete abortion. Overall, 1% of all participants had an ectopic pregnancy.
Dr. Kristina Gemzell-Danielsson, a professor of obstetrics and gynecology at Karolinska Institute, stated, "Very early medical abortion was just as effective and safe to perform, even in case of an undiagnosed ectopic pregnancy."
Patient Experience
Notably, women in the early group reported experiencing less pain and bleeding compared to those in the delayed group. This suggests potential benefits to offering medication abortion as early as possible.
Addressing Ectopic Pregnancy Concerns
One of the primary reasons for delaying medication abortions is the concern for ectopic pregnancies, where the embryo implants outside the uterus, often in the fallopian tubes. These pregnancies are not terminated by medication abortion and can be life-threatening. The study found that early medication abortion remained safe even in cases of undiagnosed ectopic pregnancy.
Future Research
Researchers are now investigating new drug combinations for early abortion that might also be effective in treating ectopic pregnancies. Additionally, they are developing new contraceptives based on mifepristone, one of the drugs used in medication abortions. According to Dr. Gemzell-Danielsson, a lower dose of mifepristone could potentially be used to prevent unwanted pregnancies in the form of a weekly or on-demand tablet.
Implications
Lead researcher Dr. Karin Brandell, a gynecologist at Karolinska University Hospital in Sweden, emphasized the importance of this research, particularly in regions with restrictive abortion laws. "It was therefore important to show that early abortion is equivalent to current standard procedure at a later stage of pregnancy," Brandell said.
