Cochrane · systematic review · CD002855
Medical methods for first trimester abortion
Zhang, J, Zhou, K, Shan, D, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Fertility RegulationAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
40
current version
GRADE rated
29
No studies
11
Included studies
NR
No studies 11 · 27.5%Ungraded 0 · 0%Very low 4 · 10%Low 16 · 40%Moderate 9 · 22.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Mifepristone (600 mg) plus prostaglandin versus mifepristone (200 mg) plus prostaglandin for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Mifepristone (600 mg) plus prostaglandin vs mifepristone (200 mg) plus prostaglandin | RR 1.07 [0.87, 1.33] | 4 studies · 3494 participants | Moderate Downgraded: inconsistency |
Nausea Mifepristone (600 mg) plus prostaglandin vs mifepristone (200 mg) plus prostaglandin | RR 1.02 [0.95, 1.09] | 2 studies · 2432 participants | Moderate Downgraded: inconsistency |
Women's dissatisfaction with the procedure Mifepristone (600 mg) plus prostaglandin vs mifepristone (200 mg) plus prostaglandin | no estimate extracted | NR | No studies |
Blood transfusion Mifepristone (600 mg) plus prostaglandin vs mifepristone (200 mg) plus prostaglandin | no estimate extracted | NR | No studies |
Misoprostol 800 µg plus mifepristone 200 mg versus misoprostol 400 µg plus mifepristone 200 mg for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Misoprostol 800 µg plus mifepristone 200 mg vs misoprostol 400 µg plus mifepristone 200 mg | RR 0.63 [0.51, 0.78] | 3 studies · 4424 participants | Moderate Downgraded: inconsistency |
Nausea Misoprostol 800 µg plus mifepristone 200 mg vs misoprostol 400 µg plus mifepristone 200 mg | RR 0.99 [0.94, 1.05] | 3 studies · 4424 participants | Moderate Downgraded: inconsistency |
Women's dissatisfaction with the procedure Misoprostol 800 µg plus mifepristone 200 mg vs misoprostol 400 µg plus mifepristone 200 mg | RR 0.75 [0.6, 0.93] | 3 studies · 4420 participants | Moderate Downgraded: inconsistency |
Blood transfusion Misoprostol 800 µg plus mifepristone 200 mg vs misoprostol 400 µg plus mifepristone 200 mg | no estimate extracted | NR | No studies |
Medical abortion self‐administered at home compared to administered in hospital for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Medical abortion self‐administered at home vs administered | RR 1.63 [0.68, 3.94] | 4 studies · 2263 participants | Low Downgraded: risk of bias, inconsistency |
Nausea Medical abortion self‐administered at home vs administered | RR 1.09 [0.74, 1.61] | 3 studies · 1532 participants | Low Downgraded: risk of bias, inconsistency |
Women's dissatisfaction with the procedure Medical abortion self‐administered at home vs administered | RR 1.63 [0.95, 2.8] | 4 studies · 2155 participants | Low Downgraded: risk of bias, inconsistency |
Blood transfusion Medical abortion self‐administered at home vs administered | RR 0.33 [0.01, 8.18] | 1 study · 731 participants | Very low Downgraded: risk of bias, imprecision |
Medical abortion administered by nurses compared to by doctors for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Medical abortion administered by nurses vs by doctors | RR 2.69 [1.39, 5.22] | 3 studies · 3056 participants | Low Downgraded: risk of bias, inconsistency |
Nausea Medical abortion administered by nurses vs by doctors | no estimate extracted | NR | No studies |
Women's dissatisfaction with the procedure Medical abortion administered by nurses vs by doctors | RR 2.7 [0.16, 44.49] | 2 studies · 1988 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Blood transfusion Medical abortion administered by nurses vs by doctors | no estimate extracted | 1 study · 1068 participants | Low Downgraded: risk of bias |
Oral misoprostol compared to vaginal misoprostol for first trimester abortion in combined regimen mifepristone/prostaglandin
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Oral misoprostol vs vaginal misoprostol | RR 2.38 [1.46, 3.87] | 3 studies · 1704 participants | Moderate Downgraded: risk of bias, inconsistency |
Nausea Oral misoprostol vs vaginal misoprostol | RR 1.14 [1.03, 1.26] | 2 studies · 1380 participants | Low Downgraded: risk of bias, inconsistency |
Women's dissatisfaction with the procedure Oral misoprostol vs vaginal misoprostol | no estimate extracted | NR | No studies |
Blood transfusion Oral misoprostol vs vaginal misoprostol | no estimate extracted | NR | No studies |
Sublingual misoprostol compared to vaginal misoprostol for first trimester abortion in combined regimen mifepristone/prostaglandin
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Sublingual misoprostol vs vaginal misoprostol | RR 0.68 [0.22, 2.11] | 2 studies · 3229 participants | Moderate Downgraded: inconsistency |
Nausea Sublingual misoprostol vs vaginal misoprostol | RR 1.11 [0.93, 1.33] | 3 studies · 3543 participants | Moderate Downgraded: inconsistency |
Women's dissatisfaction with the procedure Sublingual misoprostol vs vaginal misoprostol | RR 1.67 [0.8, 3.5] | 2 studies · 3303 participants | Moderate Downgraded: inconsistency |
Blood transfusion Sublingual misoprostol vs vaginal misoprostol | no estimate extracted | NR | No studies |
Mifepristone alone compared to mifepristone/prostaglandin for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Mifepristone alone vs mifepristone/prostaglandin | RR 3.25 [0.81, 13.09] | 3 studies · 273 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Nausea Mifepristone alone vs mifepristone/prostaglandin | no estimate extracted | NR | No studies |
Women's dissatisfaction with the procedure Mifepristone alone vs mifepristone/prostaglandin | no estimate extracted | NR | No studies |
Blood transfusion Mifepristone alone vs mifepristone/prostaglandin | no estimate extracted | NR | No studies |
Prostaglandin alone compared to combined regimen for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Prostaglandin alone vs combined regimen | RR 2.39 [1.89, 3.02] | 18 studies · 3471 participants | Low Downgraded: risk of bias, inconsistency |
Nausea Prostaglandin alone vs combined regimen | RR 0.9 [0.74, 1.1] | 12 studies · 2722 participants | Low Downgraded: risk of bias, inconsistency |
Women's dissatisfaction with the procedure Prostaglandin alone vs combined regimen | RR 1.65 [0.75, 3.64] | 5 studies · 1485 participants | Low Downgraded: risk of bias, inconsistency |
Blood transfusion Prostaglandin alone vs combined regimen | RR 0.33 [0.03, 3.13] | 1 study · 300 participants | Low Downgraded: risk of bias, imprecision |
Oral misoprostol alone compared to vaginal misoprostol alone for first trimester abortion
Population: women undergoing first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Oral misoprostol alone vs vaginal misoprostol alone | RR 3.68 [1.56, 8.71] | 2 studies · 216 participants | Low Downgraded: risk of bias, imprecision |
Nausea Oral misoprostol alone vs vaginal misoprostol alone | RR 1.21 [0.92, 1.61] | 2 studies · 216 participants | Low Downgraded: risk of bias, imprecision |
Women's dissatisfaction with the procedure Oral misoprostol alone vs vaginal misoprostol alone | RR 1.25 [0.65, 2.39] | 1 study · 100 participants | Low Downgraded: risk of bias, imprecision |
Blood transfusion Oral misoprostol alone vs vaginal misoprostol alone | no estimate extracted | NR | No studies |
Sublingual misoprostol alone compared to vaginal misoprostol alone for first trimester abortion
Population: first trimester abortion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failure to achieve complete abortion Sublingual misoprostol alone vs vaginal misoprostol alone | RR 0.69 [0.37, 1.28] | 5 studies · 2705 participants | Low Downgraded: risk of bias, inconsistency |
Nausea Sublingual misoprostol alone vs vaginal misoprostol alone | RR 1.61 [0.78, 3.33] | 4 studies · 2505 participants | Low Downgraded: risk of bias, inconsistency |
Women's dissatisfaction with the procedure Sublingual misoprostol alone vs vaginal misoprostol alone | RR 0.14 [0.07, 0.29] | 1 study · 220 participants | Low Downgraded: risk of bias, imprecision |
Blood transfusion Sublingual misoprostol alone vs vaginal misoprostol alone | RR 5 [0.24, 102.96] | 1 study · 220 participants | Very low Downgraded: risk of bias, imprecision |