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. 2022 Oct 23;23(6):919–925. doi: 10.5811/westjem.2022.8.57929

Table 1.

Safe abortion types.

1st trimester: Medication (Induction)
  • - Regimens: Mifepristone 200 mg plus misoprostol 800 mcg or misoprostol only

  • - Typically used up to 11 weeks gestational age

  • - Vaginal bleeding begins 1–4 hours after medication administration, with pregnancy expulsion occurs 3–8 hours after medication administration

  • - Side effects can include abdominal cramping, vaginal bleeding, brief low-grade fever, headache, dizziness, nausea, vomiting, and diarrhea

  • - Efficacy approximates 95–98%

  • - Higher complication rate due to risk of failure and retained tissue

1st trimester: Uterine aspiration
  • - Procedure includes dilation of the cervix, insertion of a cannula into the uterine cavity, and aspiration of uterine contents

  • - Cervical ripening agent (e.g., misoprostol) can be used

  • - Used up to 14 weeks gestation

  • - Efficacy approximates 99%

  • - Typically requires local anesthesia and/or sedation

2nd trimester: Medication (Induction)
  • - Regimens: misoprostol (most common), mifepristone, misoprostol and mifepristone, oxytocin, carboprost, sulprostone

  • - Allows for expulsion of intact fetus

  • - Higher risk of complications compared to interventional measures, including hemorrhage and retained products

  • - Approximately 8–10% of cases require intervention for further removal

  • - May require 24 hours or longer before pregnancy expulsion is completed

2nd trimester: Dilation and evacuation
  • - Account for the majority of second-trimester abortions

  • - Short procedure time (<30 minutes once cervix is dilated)

  • - Higher efficacy rates compared to second-trimester medical abortions

  • - Risk of uterine perforation

  • - Prophylactic antibiotics are administered

mg, milligram; mcg, microgram.