Randomized Trial of Very Early Medication Abortion
Background
Medication abortion using mifepristone and misoprostol is proven to be safe and effective. However, there is limited data on its effectiveness when the pregnancy is very early and not visible through ultrasound.
Methods
We conducted a multicenter trial involving women seeking medication abortion within 42 days of gestation, where the pregnancy was not confirmed by ultrasound. Participants were divided into two groups: one receiving immediate treatment (early-start group) and the other receiving standard care after pregnancy confirmation (standard group). The main goal was to see if complete abortion was achieved.
Results
A total of 1504 women participated across 26 sites in nine countries. In the early-start group, 95.2% achieved complete abortion, compared to 95.3% in the standard group. The difference between the two groups was minimal, indicating similar effectiveness. Ectopic pregnancies occurred in both groups, with slightly higher rates in the early-start group, but overall complications were low.
Conclusions
This study shows that medication abortion can be safely administered before confirming an intrauterine pregnancy, matching the effectiveness of the standard delayed approach.
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