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Changes Reduced Infections From Medical Abortion
Date:7/8/2009

Differences in drug use, delivery made a measurable impact in Planned Parenthood study

WEDNESDAY, July 8 (HealthDay News) -- Two changes to the way Planned Parenthood clinics perform medical abortion resulted in a 93 percent drop in the rate of serious infections, a new report says.

The changes involved administering the drug misoprostol to the area between the gum and the cheek (buccal administration), not the vagina, and introducing routine treatment with antibiotics.

"Planned Parenthood is very happy with the regimen," said Mary Fjerstad, lead author of a paper appearing in the July 9 issue of the New England Journal of Medicine.

"We've got the same head-to-head efficacy as with vaginal delivery and a significant reduction in infections. And, since we added antibiotics, we have a further drop in serious infections," added Fjerstad, a nurse practitioner who was director of clinical quality improvement at the Planned Parenthood Federation of America when the study was conducted. She is now a senior clinical advisor at Ipas, a nonprofit organization in El Cajon, Calif., dedicated to increasing women's sexual and reproductive rights.

Some 300 Planned Parenthood clinics in the United States provide medical abortion, which is an abortion induced by medication rather than surgery.

There are three methods of medical abortion: misoprostol alone; methotrexate followed by misoprostol; and mifepristone (the so-called "abortion pill") followed by misoprostol. The combination of mifepristone and misoprostol is the most commonly used method. Mifepristone received approval from the U.S. Food and Drug Administration for use in medical abortion in 2000.

From 2001 to March of 2006, Planned Parenthood health clinics generally provided medical abortions with a combination of mifepristone, given orally, followed 24 to 48 hours later with misoprostol administered vaginally.

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