Mifepristone Antagonization with Progesterone to Avert Medication Abortion: A Scoping Review-Reference-Cited by-同舟云学术

Mifepristone Antagonization with Progesterone to Avert Medication Abortion: A Scoping Review

Published:2023-05-29 Issue:4 Volume:90 Page:395-407
ISSN:0024-3639
Container-title:The Linacre Quarterly
language:en
Short-container-title:Linacre Q

Author:

DeBeasi Paul L. C.¹^ORCID

Affiliation:

1. University of Mary, Bismarck, ND, USA

Abstract

The safety and efficacy of mifepristone antagonization with progesterone to avert medication abortion, also known as abortion pill rescue, is a subject of vigorous debate. Two prominent medical associations have taken positions that either entirely reject or fully support its use. This scoping review aimed to gain insight into the safety and efficacy of its use. Analysis of 16 studies showed that the continuing pregnancy rate after ingesting mifepristone alone is ≦25 percent for gestational ages ≦49 days. Analysis of four studies showed that two-thirds of the women who changed their minds and received progesterone after initiating their medication abortion with mifepristone could safely continue their pregnancies. There is no increased maternal or fetal risk from using bioidentical progesterone in early pregnancy. If a woman has already taken mifepristone for her medication abortion and then changes her mind, timely supplementation with progesterone may allow her pregnancy to continue. The conclusion that mifepristone antagonization with progesterone is a safe and effective treatment has implications for medication abortion informed consent. Summary: Two-thirds of the women who changed their minds and received progesterone after initiating their medication abortion with mifepristone could safely continue their pregnancies. If a woman has already taken mifepristone for her medication abortion and then changes her mind, timely supplementation with progesterone may allow her pregnancy to continue. Physicians should disclose this treatment option to their patients at the time of informed consent.

Publisher

SAGE Publications

Subject

Health Policy,Philosophy

Link

http://journals.sagepub.com/doi/pdf/10.1177/00243639231176592

Reference50 articles.

1. AAPLOG. 2019. “2019 AAPLOG Position Statement on Abortion Pill Reversal.” Accessed March 22, 2023. https://aaplog.org/wp-content/uploads/2019/02/2019-AAPLOG-Statement-on-Abortion-Pill-Reversal.pdf.

2. AAPLOG. 2022. “The Reversal of the Effects of Mifepristone by Progesterone, Practice Guideline 6.” Accessed March 22, 2023. https://aaplog.org/wp-content/uploads/2023/01/PG-6-Reversal-of-the-Effects-of-Mifepristone-by-Progesterone.pdf.

3. Abortionrx.com. 2023. “RU486 Kit.” Accessed March 22, 2023. https://www.abortionrx.com/abortion-pills.html.

4. ACOG. 2020. “Medication Abortion up to 70 Days of Gestation.” Accessed March 22, 2023. https://www.acog.org/en/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation.