Women Who Undergo Medical, Surgical Abortions Have Similar Risk Of Tubal Pregnancy

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Women who undergo medical abortions with the pills mifepristone andmisoprostol have no greater risk of experiencing a tubal pregnancy ormiscarriage in future pregnancies than women who undergo surgicalabortions, according to a study published Thursday in the New England Journal of Medicine, the AP/Boston Globe reports (Stobbe, AP/Boston Globe, 8/15).

FDAin 2000 approved Mifeprex -- known generically as mifepristone -- to betaken in conjunction with the drug misoprostol to induce a medicalabortion at up to 49 days' gestation (Kaiser Daily Women's Health Policy Report, 2/22). About 8% to 10% of all abortions in the U.S. are medical abortions, according to the AP/Globe.

For the study, Jun Zhang of the National Institute of Child Health and Human Developmentand colleagues used Denmark's national abortion registry to identifynearly 12,000 women in the country who obtained an abortion between1999 and 2004. The researchers then collected data on the women'sfuture pregnancies from national patient and birth registries.

Theresearchers found that tubal pregnancies, during which a fertilized eggimplants outside the uterus, occurred in about 2.5% of women in boththe medical abortion and surgical abortion groups (AP/Boston Globe,8/15). The study also found about 12% of the women in both groupsexperienced a miscarriage. Women in the medical abortion group had aslightly lower risk of giving birth prematurely or of having alow-birthweight infant, but the difference was not statisticallysignificant, Reuters reports.

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Researchers' Comments, Reaction

The researchers looked at only the first pregnancy after the abortionand did not compare pregnancy outcomes among women who had a medicalabortion and women who had never had an abortion. The researchers saidthat women who have never had an abortion often have different incomes,smoking rates and other health-related behaviors that would make itdifficult to compare them to women who had abortions (Emery, Reuters,8/15). "We chose not to compare women who had medical abortionsdirectly with women who had no prior abortions, since these groupsdiffer with respect to factors that affect pregnancy outcomes," theresearchers wrote.

The conservative group Concerned Women for America said the study is "misleading," the Newark Star-Ledger reports."It's most likely that women who have not had any abortions have safer(pregnancy) outcomes than women who have had either surgical or medicalabortions," CWFA President Wendy Wright said (Stewart, Newark Star-Ledger,8/16). The researchers wrote, "Many studies have concluded thatsurgical abortion in the first trimester does not increase the risk ofectopic pregnancy, spontaneous abortion, preterm birth or lowbirthweight in subsequent pregnancies," the researchers wrote (Reuters, 8/15).

Matthew Reeves -- a reproductive medicine expert at the University of Pittsburgh School of Medicine,who was not involved in the research -- said the study "kind ofsquashes" any concerns that embryonic material left in the uterus aftermedical abortions could interfere with future pregnancies (AP/Boston Globe, 8/15).

"Mifepristonemedication abortion is a safe, effective option for early pregnancytermination," Vanessa Cullins, vice president for medical affairs for Planned Parenthood Federation of America,said, adding, "The data from this study shows health care providers andwomen that medication abortion compares very well with surgicalabortion for safety and effectiveness for women who want to planhealthy pregnancies in the future" (HealthDay News/Forbes, 8/15).
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