Misoprostol-Only for First-Trimester Medication Abortion:

An Updated Systematic Review and Meta-Analysis

An update (2023) to our prior systematic review (2019) continues to support the key conclusion that misoprostol-only is effective and safe for early medication abortion and is a reasonable alternative if mifepristone is unavailable or inaccessible. It shows that most people (85%) had complete abortion without a procedure or medications beyond the planned misoprostol regimen, regimens with certain characteristics may be especially effective (89%), and extremely few people (at most 0.2%) required hospitalization or blood transfusion. A mifepristone-misoprostol combined regimen for medication abortion has indisputable advantages over misoprostol only and is generally recognized as more efficacious (~97%). Policymakers should advocate for greater availability and access to mifepristone. 

Raymond, E. G., Weaver, M. A., Shochet, T. Effectiveness and Safety of Misoprostol-Only for First-Trimester Medication Abortion: An Updated Systematic Review and Meta-Analysis Contraception; 2023 July 28; 110132. doi: 10.1016/j.contraception.2023.110132.

Gynuity Health Projects will be in Paris at the FIGO congress next month representing the team behind TeleAborto, a direct-to-patient telemedicine service offering guided self-managed abortion in Mexico. Building on favorable results from our prior observational study, the oral presentation will focus on latest efforts to service people from across both Mexican borders (U.S. and Guatemala) and improve access for more vulnerable and indigenous populations in Oaxaca. Mark your diaries and join us in person on October 12th for this highly topical presentation, which follows on the heels of a Mexico Supreme Court decision decriminalizing abortion nationwide and requiring federal health services to offer abortion.

Breakfast with the Experts - Ethiopia and Uganda: Congo Red Test for Identification of Preeclampsia

Join our colleague from the University of Illinois, Chicago (UIC) on October 12th to discover more about a study that set out to understand the feasibility of introducing a diagnostic screening tool for early identification of preeclampsia in antenatal care services. Gynuity Health Projects has been engaged in the development and evaluation of this point-of-care test using Congo red dye for a decade and worked closely with UIC and research partners in Ethiopia and Uganda providing technical support in preparation for the latest study’s successful launch last year. 

We held a national dissemination meeting with local partners in Ukraine to share the promising results from a study piloted in Kyiv and Poltava that evaluated a telemedicine medication abortion model offering remote communication between patient and provider and limiting medically unnecessary in-person clinic visits or facility-based tests. More than 400 people registered to attend the virtual event that highlighted an approach facilitating access to and provision of high-quality abortion care during Russia’s full-scale military operation in Ukraine. 

Top scoring abstracts of the RCOG World Congress 2023 were accepted for publication. The BJOG special issue included an abstract, under the Hot Topics (Emerging Research/Issues) in Obstetrics category, about an evaluation tool designed to understand birth experiences and satisfaction levels of women undergoing induction of labor for a pregnancy complicated by hypertension. The study is part of ‘MOLI: Misoprostol or Oxytocin for Labour Induction’, the latest joint project of the University of Liverpool in the U.K. with Gynuity Health Projects and clinical sites in Nagpur, India. 

In Cover Up: The Pill Plot, the host charts how mifepristone came to the U.S. in the 1990s. Episode six from the seven-part podcast series describes the lead up to authorization and includes clips from an interview with Beverly Winikoff, founder and president of Gynuity Health Projects, who at the time was on the team from the Population Council helping to secure Food and Drug Administration approval nearly a quarter century ago.

Despite providing important individual and public health benefits since 2000, mifepristone has become a target in the U.S. for opponents of abortion who are seeking to limit its access nationwide. This month, the federal government and a drug manufacturer asked the U.S. Supreme Court to review a lower court decision invalidating changes the FDA approved to the conditions of use for mifepristone regarding the dosing regimen, gestational age limit, and in-person dispensing requirements, among other things. A compendium of published research articles illustrates the large number of studies by Gynuity Health Projects staff and colleagues that consistently show the safety and effectiveness of mifepristone.