A recent international study led by researchers from Karolinska Institutet suggests that very early medication abortion can be just as safe and effective as waiting until ultrasound confirms an intrauterine pregnancy, often done in weeks five or six. Traditionally, clinics delay the procedure until ultrasound verification to rule out ectopic pregnancy, a potentially life-threatening condition where the embryo attaches outside the uterus. However, the study, published in The New England Journal of Medicine, found that early abortions, between weeks four and six, had comparable success rates and safety to later procedures. Conducted across nine countries and involving over 1,500 women, the VEMA (Very Early Medical Abortion) study split participants into two groups: one receiving abortion care upon intrauterine confirmation and the other receiving early care. Both groups were given the drugs mifepristone and misoprostol, commonly used for medication abortions.
Results showed that over 95% of women in both groups experienced complete abortion. However, minor differences emerged: in the delayed group, incomplete abortions requiring further surgery occurred in 4.5% of cases, whereas in the early group, the continuation of pregnancy happened in 3% of cases, and incomplete procedures requiring surgical intervention occurred in 1.8% of cases. Additionally, women in the early group reported experiencing less pain and bleeding. The researchers, including Karin Brandell, first author and gynecologist, emphasized that access to early abortion is crucial, especially in regions with restrictive laws, like Texas, where abortion is banned after the sixth week.
The researchers are now exploring alternative drug combinations for early abortion that might also address ectopic pregnancies and are testing mifepristone in low doses as a potential new contraceptive. This study was supported by various research funds, including the Swedish Research Council and the European Society of Contraception and Reproductive Health.
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