Two scientific studies led by researchers at Sweden’s Karolinska Institutet are expected to form the basis of new international recommendations for the treatment of medical abortions and miscarriages. One of the studies, both of which are being published in the journal The Lancet, shows that it is possible to replace the clinical follow-up examinations recommended today with medical abortions that include a home pregnancy test. The other study shows that midwives can safely and effectively treat failed abortions and miscarriages in rural districts of Uganda.

The term 'incomplete abortion' is when there is residual tissue in the uterus following a failed abortion treatment or spontaneous abortion (miscarriage). This can result in bleeding and infection and is a potentially life-threatening condition that can effectively be treated with the medicine misoprostol. Misoprostol is a prostaglandin analogue that causes the uterus to contract and empty its contents.

With funding from WHO, researchers at Karolinska Institutet and colleagues from Makerere University in Uganda have conducted a study that includes around 1,000 women from rural districts of Uganda. The women had visited the health centres with complications following failed abortions or miscarriages. They were selected at random for treatment with misoprostol from either a midwife or doctor. The women were given a dose of the drug in tablet form at the health centre. After a few hours they were sent home with antibiotics, pain-relief tablets and were instructed to seek medical attention if they developed a temperature, or had pain or vaginal discharge. When the women were examined after two weeks, around 95 percent of the treatments had been performed safely and effectively, and the figure was as high for the midwives as it was for the doctors. The women who still had residual tissue in the uterus were given surgical treatment.

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For more information about this research, please contact:

Kristina Gemzell Danielsson, MD, PhD,
Professor, the Department of Women's and Children's Heath, Obstetrics and Gynaecology Unit at Karolinska Institutet
Tel: +46 8 517 721 28 or +46 70 910 78 21
E-mail: kristina.gemzell@ki.se

Marie Klingberg-Allvin, PhD,
Senior lecturer, Department of Women's and Children's Heath, Obstetrics and Gynaecology Unit at Karolinska Institutet,
also Pro Vice-Chancellor at Dalarna University
Tel: +46 23 77 84 69 or +57 70 717 44 14
E-mail: mkl@du.se

Related Links

About Mak-KI Collaboration: https://kiedit.ki.se/en/about/collaboration-with-uganda

Research on medical abortion and miscarriage may change international routines