Medical abortions effective from very early stages of pregnancy

A new study has found that medical abortions are safe and effective even before a pregnancy is detected by ultrasound.

Professor Sharon Cameron and Dr John Reynolds-Wright from the Centre for Reproductive Health collaborated on the clinical trial led by the Karolinska Institute in Sweden. 

A medical abortion involves taking prescription pills of mifepristone and misoprostol to end a pregnancy. Currently the standard approach is to wait until a pregnancy has been confirmed by ultrasound, usually after week 6 of a pregnancy. 

The VEMA study has shown that medical abortion at a very early stage of pregnancy,  before a pregnancy can be seen using ultrasound, is as safe and effective as waiting until the ultrasound can confirm a pregnancy.  

Medical abortion (or medication abortion) has been used as a highly effective and safe form of abortion for decades. Until now, there has been a lack of evidence to prove the safety and effectiveness of this treatment before the pregnancy is visible using ultrasound. 

The study allows women who want to end a pregnancy to choose medical abortion at this early stage. This is beneficial as it minimises delay and there is less bleeding at earlier stages. This is especially important in settings (including parts of USA) where abortion is restricted after early gestation.

Professor Sharon Cameron

Participants who were seeking early medical abortions and consented to take part in the trial were randomly divided into two groups. One group, where women had unconfirmed intrauterine pregnancies, started the medical abortion immediately. The second group had treatment delayed until their pregnancies were confirmed using ultrasound.

The four-year study, which involved over 1,500 women from 26 sites across 9 countries, found that an early start of medication was not inferior to standard care with respect to complete abortion.  

This work was funded by the Swedish Research Council and published in the New England Journal of Medicine. 

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