Safety and efficacy of early medical abortion at home between 10+0 and 11+6 weeks' gestation: a retrospective review.

IF 2.8 3区医学 Q1 FAMILY STUDIES

BMJ Sexual & Reproductive Health Pub Date : 2025-10-02 DOI:10.1136/bmjsrh-2025-202947

Jacqueline Quinn, John Joseph Reynolds-Wright, Karen McCabe, Sharon T Cameron

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引用次数: 0

Abstract

Introduction: Since 2020, legislation in Britain has allowed both mifepristone and misoprostol to be taken at home for early medical abortion (EMA). In England and Wales, legislation restricts this to 9+6 weeks, but in Scotland this is permitted up to 11+6 weeks. Data on the outcomes of EMA at home >10 weeks' gestation is limited and so we aimed to establish the safety and efficacy of this in comparison with EMA in a hospital setting.

Methods: We conducted a retrospective review from our abortion service in Edinburgh, Scotland of outcomes of EMA at home versus hospital between 10+0 and 11+6 weeks' gestation over the 5-year period April 2020-March 2025. The primary outcome was complete abortion rate. Secondary outcomes were rates of incomplete abortion, ongoing pregnancy and serious complications.

Results: A total of 371 EMAs occurred at this gestation (n=258 home, n=113 hospital). Complete abortion rates were not statistically significantly different between groups: 251/258 (97%) (95% CI: 94% to 99%) at home and 110/113 (97%) (95% CI: 92% to 99%) in hospital. Neither incomplete abortion rates (home: 4/258, 1.6%; hospital: 3/113, 2.6%) nor ongoing pregnancy rates (home: 3/258, 1.2%; hospital: 0/113, 0%) were significantly different between groups. There was one case of haemorrhage requiring transfusion and three cases of infection receiving intravenous antibiotics, all in the at home group.

Conclusions: EMA at home between 10+0 and 11+6 weeks has the same high efficacy and safety as when conducted in hospital. Action is needed to extend EMA at home after 10 weeks' gestation to women across the rest of the UK and beyond.

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妊娠10+0 ~ 11+6周早期在家药物流产的安全性和有效性：回顾性分析

导言：自2020年以来，英国立法允许在家中服用米非司酮和米索前列醇进行早期药物流产（EMA）。在英格兰和威尔士，法律将假期限制在9+6周，但在苏格兰，最长可达11+6周。关于妊娠10周家庭EMA结果的数据有限，因此我们的目标是将其与医院环境中的EMA进行比较，以确定其安全性和有效性。方法：我们对我们在苏格兰爱丁堡的流产服务进行了回顾性分析，比较了2020年4月至2025年3月5年间妊娠10+0周至11+6周期间在家中和医院进行EMA的结果。主要观察指标为完全流产率。次要结局是不完全流产、持续妊娠和严重并发症的发生率。结果：该妊娠期共发生EMAs 371例（家庭258例，医院113例）。完全流产率组间差异无统计学意义：251/258 (97%)（95% CI: 94% ~ 99%）在家中，110/113 (97%)（95% CI: 92% ~ 99%）在医院。不完全流产率（家庭：4/258,1.6%；医院：3/113,2.6%）和持续妊娠率（家庭：3/258,1.2%；医院：0/113,0%）两组间均无显著差异。有1例出血需要输血，3例感染接受静脉注射抗生素，都在家庭组。结论：10+0 ~ 11+6周在家进行EMA与在医院进行EMA具有相同的高疗效和安全性。需要采取行动，将妊娠10周后家中的EMA扩展到英国其他地区及其他地区的女性。

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

BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine

CiteScore

5.10

自引率

6.10%

发文量

期刊介绍： BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.