A review of developments in medical termination of pregnancy.
OBJECTIVE
This literature review aims to supplement guidelines by providing an overview of recent evidence relevant to medical termination of pregnancy.


BACKGROUND
Termination of pregnancy is available to women in the UK within legal parameters. Although guidelines form a strong body of evidence on which nurses and midwives can base their practice, there is a need to supplement them with up-to-date robust research findings.


METHODS
A systematic search of the literature with high sensitivity and low specificity was undertaken on five databases using medical subject headings (MeSH) terms including (medical) induced abortion, therapeutic abortion and termination of pregnancy.


RESULTS
The literature search revealed articles under the following headings: The importance of choice for the women involved the need for the optimal medication type, dose, route and interval between stages one and two, and the optimum place for medical termination to take place.


CONCLUSIONS
It was found that women attach a great deal of importance to the opportunity to choose their method of termination. The first stage of mifepristone is now a standard practice and an optimum dose has been determined. Several studies examined misoprostol used in the second stage of medical termination. There was some evidence for repeated doses of misoprostol, particularly in later gestation, with conflicting evidence on the optimal route. There were some grounds for reducing the interval between stages. Consideration should be given to home medical termination based on individual circumstances and choice. Gestation and previous obstetric history is an important factor to take into account when determining optimal regimen. Relevance to clinical practice. The number of medical termination of pregnancies performed has risen in recent years together with the nurses' involvement. As new research is published, it is imperative that nurses adapt to base their involvement on the best available evidence.
Lipp
Allyson
A
Faculty of Health, Sport and Science, University of Glamorgan, Pontypridd, UK. alipp@glam.ac.uk
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000331:legislation & jurisprudence / Q000379:methods* / Q000523:psychology / Q000639:trends; D000282:Administration, Intravaginal; D000284:Administration, Oral; D001294:Attitude to Health; D002755:Choice Behavior; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage; D016595:Misoprostol / Q000008:administration & dosage; D024802:Nurse's Role; D015399:Nursing Research; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D013997:Time Factors; D006113:United Kingdom
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone