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Objective: Early pregnancy loss is a common complication of pregnancy. Research has demonstrated the efficacy of Mifepristone pre-treatment followed by Misoprostol for the induction of an early pregnancy loss (EPL). North York General Hospital (NYGH) provides an all-in-one Early Pregnancy Assessment Clinic (EPAC) to streamline the care of women with an EPL.

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Background: The current regimen for early medication abortion in many countries is mifepristone and misoprostol, but mifepristone is relatively expensive and limited in many regions. Ulipristal acetate, with a similar chemical profile, might be an alternative. This proof-of-concept study evaluated ulipristal acetate and misoprostol for medication abortion through 63 days of gestation.

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Perspectives on Abortion Services, the Pre-Abortion Visit, and Telemedicine Abortion: A Qualitative Study in Sweden.

Perspect Sex Reprod Health

January 2025

Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

Context: According to Swedish law, abortion treatment should be carried out at an approved healthcare facility. All persons seeking medication abortions are obliged to attend an in-person visit, which includes a gynecological examination, an ultrasound scan, and administration of mifepristone at a hospital/clinic. However, some countries have implemented telemedicine abortion services without the requirement of in-person visits during and after the COVID-19 pandemic.

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Society of Family Planning Clinical Recommendation: Medication management for early pregnancy loss.

Contraception

December 2024

Planned Parenthood South Atlantic, Raleigh, NC, USA and McLeod Regional Medical Center, Florence, SC, USA; University of Washington Department of Obstetrics and Gynecology, 1959 NE Pacific St, Box 356460, Seattle, WA 98005, USA; Pegasus Health Justice Center, Dallas, TX, 75207, USA; Washington University, St. Louis, MO, USA.

Early pregnancy loss (EPL), also known as miscarriage or spontaneous abortion, makes up 15-20% of all clinically recognized pregnancies. EPL is a broad term that includes intrauterine pregnancies (IUPs) with findings that suggest the pregnancy may not progress or definitely will not progress; pregnancies with a gestational sac (GS) in the lower endometrial cavity or endocervical canal in the process of expulsion; residual pregnancy tissue or persistent GS; and complete passage of the GS without residual tissue. This document addresses medication management of EPL in which the complete passage of the GS has not yet occurred, including pregnancies concerning for and diagnostic of EPL (sometimes called "missed abortion") and EPL in progress.

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