A systematic review in 2017 supported “the use of medical abortion at gestational ages <42 days. Efficacy rates were high overall and appeared to reflect those observed during the 7th week of pregnancy. Women who prefer to initiate treatment as soon as early pregnancy is diagnosed may do so without delay. It concludes that “further research of abortion outcomes disaggregated by gestational age and visualization of the gestational sac is warranted”.
A cohort study, also in 2017, found that “medical abortion before confirmed intrauterine pregnancy was as effective as at later gestation with less incomplete abortions. It says that the risk of ectopic pregnancy needs to be considered if treatment is initiated before an intrauterine pregnancy is confirmed, but with structured clinical protocols the possibility of the early detection of an asymptomatic ectopic pregnancy may increase”.
In June 2018, FIAPAC wrote: “More and more women come early for a medical abortion, sometimes even before the location of the pregnancy can be determined. Colleagues handle these situations differently, some wait for 1-2 weeks; some start treatment immediately. And so far there is no recognized standard or best practice. Therefore, FIAPAC is conducting an anonymous online survey to collect data on current practice and experience with very early medical abortion. The results will be published at the FIAPAC conference and on the website and will help to improve the guidelines for medical abortion. Please complete this very short online survey and share with colleagues before 31 July.
SOURCES: Efficacy of medical abortion prior to 6 gestational weeks: a systematic review, by Nathalie Kapp, Maureen K Baldwin, Maria Isabel Rodriguez. Contraception 2018 Feb;97(2):90–99 ; Efficacy and safety of very early medical termination of pregnancy: a cohort study, by I Bizjak, C Fiala, L Berggren et al. BJOG 2017 Dec;124(13):1993-99 ; E-mail, from Christian Fiala, FIAPAC, 21 June 2018. PHOTO by Olga Loeber, Reproductive Health Matters, 2010.