{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:41:30Z","timestamp":1771328490910,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"3","funder":[{"name":"Anonymous donor"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,5,16]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>We aimed to assess the feasibility and acceptability of a second-trimester medical abortion regimen using mifepristone and sublingual misoprostol with no maximum number of misoprostol doses in Uzbekistan and Ukraine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective open-label study enrolled 306 women with pregnancies of 13\u201322 weeks in Uzbekistan (n=134) and Ukraine (n=172). Women took 200\u2009mg mifepristone at a place of their choosing, and 24\u201348\u2009hours later received 400 \u03bcg sublingual misoprostol every 3 hours until the expulsion of both fetus and placenta. Study staff interviewed women about the intensity of pain, side effects, and satisfaction with the procedure. The primary outcome was the rate of complete uterine evacuation without surgical intervention or oxytocin at 15 hours after the first dose of misoprostol.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median gestational age was 18.1 weeks, and half of the women (n=149, 48.9%) chose to take mifepristone at home. The majority of women (n=266, 86.9%, 95%\u2009CI 82.6% to 90.5%) expelled by 15 hours after the start of misoprostol treatment, and by 48 hours complete uterine evacuation was achieved in 296 (96.7%) women. Most women found pain (76.1%) and side effects (89.0%) to be acceptable or very acceptable, and reported high satisfaction (89.8%) with the procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Medical abortion in pregnancies of 13\u201322 weeks with 200\u2009mg mifepristone followed 24\u201348 hours later by 400 \u03bcg sublingual misoprostol administered every 3 hours until complete expulsion is effective, safe and acceptable to women. Women can be given the option to take mifepristone at home and return to the hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trials registration number<\/jats:title>\n                  <jats:p>ClinicalTrials.gov, www.clinicaltrials.gov, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02415894\">NCT02415894<\/jats:ext-link>, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02235155\">NCT02235155<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2018-200167","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T17:29:10Z","timestamp":1559669350000},"page":"177-182","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["A prospective study of mifepristone and unlimited dosing of sublingual misoprostol for termination of second-trimester pregnancy in Uzbekistan and Ukraine"],"prefix":"10.1136","volume":"45","clinical-trial-number":[{"clinical-trial-number":"nct02415894","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02235155","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5609-5393","authenticated-orcid":false,"given":"Ingrida","family":"Platais","sequence":"first","affiliation":[{"name":"Gynuity Health Projects, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar","family":"Tsereteli","sequence":"additional","affiliation":[{"name":"Gynuity Health Projects, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galyna","family":"Maystruk","sequence":"additional","affiliation":[{"name":"Woman Health & Family Planning Charity Foundation, Kiev, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilfuza","family":"Kurbanbekova","sequence":"additional","affiliation":[{"name":"Women\u2019s Wellness Center, Tashkent, Uzbekistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly","family":"Winikoff","sequence":"additional","affiliation":[{"name":"Gynuity Health Projects, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,6,4]]},"reference":[{"key":"2025090510394034000_45.3.177.1","unstructured":"Ministry of Health of Ukraine . Comprehensive care for unwanted pregnancy. Kiev: Ministry of Health of Ukraine, 2010."},{"issue":"31 Suppl.","key":"2025090510394034000_45.3.177.2","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S0968-8080(08)31371-8","article-title":"Second trimester medical abortion with mifepristone-misoprostol and misoprostol alone: a review of methods and management","volume":"16","author":"Gemzell-Danielsson","year":"2008","journal-title":"Reprod Health Matters"},{"key":"2025090510394034000_45.3.177.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/GCO.0000000000000409","article-title":"Update on second trimester medical abortion","volume":"29","author":"Lerma","year":"2017","journal-title":"Curr Opin Obstet Gynecol"},{"key":"2025090510394034000_45.3.177.4","unstructured":"World Health Organization . Safe abortion: technical and policy guidance for health systems. 134. 2nd edition. Geneva, Switzerland: World Health Organization, Department of Reproductive Health and Research, 2012."},{"key":"2025090510394034000_45.3.177.5","unstructured":"Royal College of Obtetricians and Gynecologists . The care of women requesting induced abortion. Evidence-based clinical guideline number 7. London: RCOG Press, 2011."},{"key":"2025090510394034000_45.3.177.6","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/AOG.0000000000001688","article-title":"Simultaneous administration compared with a 24-hour mifepristone-misoprostol interval in second-trimester abortion: a randomized controlled trial","volume":"128","author":"Abbas","year":"2016","journal-title":"Obstet Gynecol"},{"key":"2025090510394034000_45.3.177.7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1080\/13625187.2016.1258461","article-title":"Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia","volume":"22","author":"Louie","year":"2017","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510394034000_45.3.177.8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/ijgo.12181","article-title":"FIGO's updated recommendations for misoprostol used alone in gynecology and obstetrics","volume":"138","author":"Morris","year":"2017","journal-title":"Int J Gynaecol Obstet"},{"key":"2025090510394034000_45.3.177.9","unstructured":"National Abortion Federation . Clinical policy guidelines. Washington, DC: National Abortion Federation, 2016."},{"key":"2025090510394034000_45.3.177.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.10.021"},{"key":"2025090510394034000_45.3.177.11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei037"},{"key":"2025090510394034000_45.3.177.12","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei196"},{"key":"2025090510394034000_45.3.177.13","unstructured":". IBM SPSS statistics for Windows, version 19.0. Armonk, NY IBMCorp; 2010."},{"key":"2025090510394034000_45.3.177.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2003.09.006"},{"key":"2025090510394034000_45.3.177.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00235.x"},{"key":"2025090510394034000_45.3.177.16","unstructured":"World Health Organization . Health worker roles in providing safe abortion care and post-abortion contraception. Geneva, Switzerland: World Health Organization, 2015."}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2018-200167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:01:25Z","timestamp":1757095285000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2018-200167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,4]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,7,9]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bmjsrh-2018-200167"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2018-200167","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,4]]}}}