title: Prospective study of home use of mifepristone and misoprostol for medical abortion up to 10weeks of pregnancy in Kazakhstan.
abstract: OBJECTIVE
  To evaluate the efficacy of at-home medical abortion in Kazakhstan.
  
  
  METHODS
  A comparative, non-randomized study was undertaken at three clinics in Kazakhstan between October 10, 2013, and November 27, 2014. Women who sought medical abortion and had an intrauterine pregnancy of up to 70days were enrolled. All participants took 200mg mifepristone followed by 600μg sublingual misoprostol 24-48hours later. Women were offered the choice to take mifepristone at the clinic or at home; all took misoprostol at home. Abortion completion was assessed at an in-clinic follow-up appointment scheduled for all participants 2weeks after mifepristone administration.
  
  
  RESULTS
  Of 290 enrolled women, 185 (63.8%) chose to self-administer mifepristone at home. Three (1.0%) of 289 women included in outcome analyses required surgical intervention for incomplete abortion. Therefore, the overall success rate was 99.0% (95% confidence interval 97.0%-99.7%). No serious adverse events occurred.
  
  
  CONCLUSIONS
  Outpatient medical abortion with mifepristone and misoprostol is safe and effective up to 70days of pregnancy. This service should be offered to women in Kazakhstan. ClinicalTrials.gov: NCT02018796.
authors.affiliation: Gynuity Health Projects, New York, NY, USA. Electronic address: iplatais@gynuity.org.
authors.forename: Ingrida
authors.initials: I
authors.lastname: Platais
authors.affiliation: Gynuity Health Projects, Tbilisi, Georgia.
authors.forename: Tamar
authors.initials: T
authors.lastname: Tsereteli
authors.affiliation: Kazakhstan Association on Sexual and Reproductive Health, Almaty, Kazakhstan.
authors.forename: Galina
authors.initials: G
authors.lastname: Grebennikova
authors.affiliation: Gynuity Health Projects, New York, NY, USA.
authors.forename: Tatyana
authors.initials: T
authors.lastname: Lotarevich
authors.affiliation: Gynuity Health Projects, New York, NY, USA.
authors.forename: Beverly
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D007623:Kazakhstan; D015735:Mifepristone / Q000008:administration & dosage / Q000627:therapeutic use*; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D014932:Women's Health Services; D055815:Young Adult
chemical_list: D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone
keywords: Home use; Kazakhstan; Medical abortion; Mifepristone; Misoprostol