Medical Abortion before Confirmed Intrauterine Pregnancy: A Systematic Review.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-11-01 DOI:10.1055/s-0042-1760117

Karin Brandell, John J Reynolds-Wright, Clare Boerma, Gillian Gibson, Helena Hognert, Heera Tuladhar, Oskari Heikinheimo, Sharon Cameron, Kristina Gemzell-Danielsson

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引用次数: 1

Abstract

"Very early medical abortion" (VEMA) refers to medical abortion (with mifepristone and misoprostol) before intrauterine pregnancy is visualized on ultrasound. Our aim is to present the current evidence on efficacy, safety (focused on ectopic pregnancies), and how to assess treatment success of VEMA. We conducted a systematic review of studies reporting outcomes of VEMA. The field is small and so our objective was to map all relevant literature, without conducting meta-analysis. We searched PubMed, Medline, and Embase on April 19, 2022. We conducted a narrative synthesis of the evidence. A total of 373 articles were identified. Six articles (representing four observational and one pilot trial) were included in the final review. Across all included studies, treatment efficacy ranged between 91 and 100%. Prevalence of ectopic pregnancy was low and very few cases (n = 2) of ruptures were reported. Most studies used serial serum human chorionic gonadotrophin (s-hCG) levels to determine success of abortion; one study used low sensitivity urine hCG. From the available evidence, VEMA appears to be efficacious and does not appear to cause harm to ectopic pregnancies. Treatment can be assessed with pre- and postabortion s-hCG. Good quality, randomized controlled trial evidence is needed to best inform practice.

查看原文本刊更多论文

确认宫内妊娠前药物流产:系统综述。

“极早期药物流产”(VEMA)是指超声显示宫内妊娠前药物流产(米非司酮和米索前列醇联合用药)。我们的目的是介绍目前关于VEMA的有效性、安全性(重点是异位妊娠)以及如何评估VEMA治疗成功的证据。我们对报道VEMA结果的研究进行了系统回顾。该领域很小，因此我们的目标是绘制所有相关文献，而不进行荟萃分析。我们在2022年4月19日检索了PubMed, Medline和Embase。我们对证据进行了叙述综合。共鉴定出373件物品。6篇文章(代表4篇观察性试验和1篇试点试验)被纳入最终综述。在所有纳入的研究中，治疗效果在91%到100%之间。异位妊娠的发生率较低，报告的破裂病例极少(n = 2)。大多数研究使用连续血清人绒毛膜促性腺激素(s-hCG)水平来确定流产成功率;一项研究使用低敏感性尿hCG。从现有的证据来看，VEMA似乎是有效的，似乎不会对异位妊娠造成伤害。可以通过流产前和流产后的s-hCG来评估治疗。需要高质量的随机对照试验证据来为实践提供最佳信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.