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class="bkr_bib"><h1 id="_NBK561073_"><span itemprop="name">Expulsion at home for early medical abortion</span></h1><div class="subtitle">Abortion care</div><p><b>Evidence review G</b></p><p><i>NICE Guideline, No. 140</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Alliance (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 Sep</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3539-0</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="ch7.s1"><h2 id="_ch7_s1_">Expulsion at home for early medical abortion</h2><div id="ch7.s1.1"><h3>Review question</h3><p>For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</p><div id="ch7.s1.1.1"><h4>Introduction</h4><p>The aim of this review is to determine what gestational limit offers the best balance of benefits and harms for home expulsion of pregnancy.</p><p>At the time of development, the title of this guideline was ‘Termination of pregnancy’ and this term was used throughout the guideline. In response to comments from stakeholders, the title was changed to ‘Abortion care’ and abortion has been used throughout. Therefore, both terms appear in this evidence report.</p></div><div id="ch7.s1.1.2"><h4>Summary of the protocol</h4><p>See <a class="figpopup" href="/books/NBK561073/table/ch7.tab1/?report=objectonly" target="object" rid-figpopup="figch7tab1" rid-ob="figobch7tab1">Table 1</a> for a summary of the population, prognostic factor and outcome (PPO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch7tab1"><a href="/books/NBK561073/table/ch7.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch7tab1" rid-ob="figobch7tab1"><img class="small-thumb" src="/books/NBK561073/table/ch7.tab1/?report=thumb" src-large="/books/NBK561073/table/ch7.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PPO table)." /></a><div class="icnblk_cntnt"><h4 id="ch7.tab1"><a href="/books/NBK561073/table/ch7.tab1/?report=objectonly" target="object" rid-ob="figobch7tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PPO table). </p></div></div><p>For further details see the full review protocol in <a href="#ch7.appa">appendix A</a>.</p></div><div id="ch7.s1.1.3"><h4>Clinical evidence</h4><div id="ch7.s1.1.3.1"><h5>Included studies</h5><p>One of the original inclusion criteria was to only include studies with ≥100 women per prognostic group. With the original inclusion criteria, no studies for prognostic group >71 days (10<sup>+1</sup> weeks) were identified. However, the limit of number of women per prognostic group was lowered to 50 and this led to inclusion of 1 additional study (<a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>). Four cohort studies including 3 prospective cohort studies (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>) and 1 retrospective cohort study (<a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>) were included in this evidence review. The studies compared outcomes following home expulsion of pregnancies less than 9 weeks with those between 9 to 10 weeks or 9 to 12 weeks.</p><p>The included studies are summarised in <a class="figpopup" href="/books/NBK561073/table/ch7.tab2/?report=objectonly" target="object" rid-figpopup="figch7tab2" rid-ob="figobch7tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch7tab2"><a href="/books/NBK561073/table/ch7.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch7tab2" rid-ob="figobch7tab2"><img class="small-thumb" src="/books/NBK561073/table/ch7.tab2/?report=thumb" src-large="/books/NBK561073/table/ch7.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="ch7.tab2"><a href="/books/NBK561073/table/ch7.tab2/?report=objectonly" target="object" rid-ob="figobch7tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See the literature search strategy in <a href="#ch7.appb">appendix B</a> and study selection flow chart in <a href="#ch7.appc">appendix C</a></p></div><div id="ch7.s1.1.3.2"><h5>Excluded studies</h5><p>Studies not included in this review with reasons for their exclusions are provided in <a href="#ch7.appk">appendix K</a>.</p></div></div><div id="ch7.s1.1.4"><h4>Summary of clinical studies included in the evidence review</h4><p>A summary of the studies that were included in this review are presented in <a class="figpopup" href="/books/NBK561073/table/ch7.tab2/?report=objectonly" target="object" rid-figpopup="figch7tab2" rid-ob="figobch7tab2">Table 2</a>.</p><p>See the full evidence tables in <a href="#ch7.appd">appendix D</a> and the forest plots in <a href="#ch7.appe">appendix E</a>.</p></div><div id="ch7.s1.1.5"><h4>Quality assessment of clinical studies included in the evidence review</h4><p>See the clinical evidence profiles in <a href="#ch7.appf">appendix F</a>.</p></div><div id="ch7.s1.1.6"><h4>Economic evidence</h4><div id="ch7.s1.1.6.1"><h5>Included studies</h5><p>A systematic review of the economic literature was conducted but no economic studies were identified which were applicable to this review question.</p><p>A single economic search was undertaken for all topics included in the scope of this guideline. Please see <a href="/books/NBK561073/bin/bm2.pdf">supplementary material 2</a> for details.</p></div><div id="ch7.s1.1.6.2"><h5>Excluded studies</h5><p>No full-text copies of articles were requested for this review and so there is no excluded studies list.</p></div></div><div id="ch7.s1.1.7"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.</p></div><div id="ch7.s1.1.8"><h4>Evidence statements</h4><div id="ch7.s1.1.8.1"><h5>Critical outcomes</h5><div id="ch7.s1.1.8.1.1"><h5>Need for emergency care/hospital admission</h5><p>Evidence from cohort studies did not detect a clinically important difference in the need for emergency care/hospital admission rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (2 prospective cohort studies, n=1332; RR= 0.86 [95% CI 0.42-1.77]; very low quality); however, there was uncertainty around the estimate.</p></div><div id="ch7.s1.1.8.1.2"><h5>Haemorrhage requiring blood transfusion or > 500ml of blood loss</h5><p>Evidence from cohort studies did not detect a clinically important difference in the haemorrhage requiring blood transfusion or > 500ml blood loss rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (2 prospective cohort studies, n=1332; RR= 1.34 [95% CI 0.23, 7.94]; very low quality); however, there was uncertainty around the estimate.</p></div><div id="ch7.s1.1.8.1.3"><h5>Patient satisfaction (satisfied or very satisfied)</h5><p>Evidence from a cohort study showed there was no clinically important difference in patient satisfaction (rated as satisfied or very satisfied) following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (1 prospective cohort study, n=629; RR= 0.99 [95% CI 0.94, 1.05]; moderate quality).</p></div></div><div id="ch7.s1.1.8.2"><h5>Important outcomes</h5><div id="ch7.s1.1.8.2.1"><h5>Complete abortion without the need for surgical intervention</h5><p>Evidence from cohort studies did not detect a clinically important difference in the complete abortion without the need for surgical intervention rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestational age (1 retrospective and 3 prospective cohort studies, n=2570; RR= 1.02 [95% CI 0.99, 1.04]; very low quality); however there was uncertainty around the estimate.</p><div id="ch7.s1.1.8.2.1.1"><h5>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</h5><p>Evidence from cohort studies did not detect a clinically important difference in the complete abortion without the need for surgical intervention rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (3 prospective cohort studies, n=2292; RR= 1.02 [95% CI 1.00, 1.05]; low quality); however there was uncertainty around the estimate.</p></div><div id="ch7.s1.1.8.2.1.2"><h5>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</h5><p>Evidence from a cohort study did not detect a clinically important difference in the complete abortion without the need for surgical intervention rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestational age (1 retrospective cohort study, n=278; RR= 0.95 [95% CI 0.83, 1.08); very low quality); however there was uncertainty around the estimate.</p></div></div><div id="ch7.s1.1.8.2.2"><h5>Vomiting</h5><p>Evidence from cohort studies did not detect a clinically important difference in the vomiting rate following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (3 prospective cohort studies, n=2271; RR= 0.80 [95% CI 0.69, 0.93]; low quality); however there was uncertainty around the estimate.</p></div><div id="ch7.s1.1.8.2.3"><h5>Pain</h5><p>Evidence from cohort studies showed there was no clinically important difference in pain following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestational age (1 retrospective and 2 prospective cohort studies, n=1941; RR= 0.91 [95% CI 0.81, 1.03]; very low quality).</p><div id="ch7.s1.1.8.2.3.1"><h5>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</h5><p>Evidence from cohort studies showed there was no clinically important difference in pain following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (2 prospective cohort studies, n=1663; RR= 0.91 [95% CI 0.81, 1.02]; low quality).</p></div><div id="ch7.s1.1.8.2.3.2"><h5>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</h5><p>Evidence from a cohort study did not detect a clinically important difference in pain following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestational age (1 retrospective cohort study, n=278; RR= 1.71 [95% CI 0.20, 14.43); very low quality); however there was uncertainty around the estimate.</p></div></div><div id="ch7.s1.1.8.2.4"><h5>Diarrhoea</h5><p>Evidence from cohort studies did not detect a clinically important difference in diarrhoea following home expulsion after taking mifepristone and misoprostol for a medical abortion between pregnancies ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestational age (3 prospective cohort studies, n=2272; RR= 0.85 [95% CI 0.73, 0.99)]; low quality); however there was uncertainty around the estimate.</p></div></div></div><div id="ch7.s1.1.9"><h4>The committee’s discussion of the evidence</h4><div id="ch7.s1.1.9.1"><h5>Interpreting the evidence</h5><div id="ch7.s1.1.9.1.1"><h5>The outcomes that matter most</h5><p>The committee agreed that, although the need for emergency care/hospital admission is rare in women having home expulsion for medical abortion, this was a critical outcome for decision making given its seriousness and implications for the woman and the health care resources. Haemorrhage requiring transfusion or greater than 500ml of blood loss was also considered a critical outcome for decision making, because of the seriousness of the outcome. One of the main objectives of offering a choice for home expulsion is providing the convenience to stay at home and make the service more acceptable and improve satisfaction. Therefore patient satisfaction was also included as a critical outcome.</p><p>Complete abortion without the need for surgical intervention was selected as an important outcome as this may have implications for the woman in terms of having to undergo surgical intervention and also impact resources. Vomiting, pain and diarrhoea were included as important outcomes to allow for a balance of the benefits and harms as the likelihood of these occurring increases with increasing gestational age and they are likely to impact patient satisfaction.</p></div><div id="ch7.s1.1.9.1.2"><h5>The quality of the evidence</h5><p>A modification of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to evaluate the quality of the evidence for, and confidence in, each outcome in the evidence review. The evidence for the need for emergency care/hospital admission was very low quality; the main reason evidence was downgraded was for imprecision due to wide confidence intervals caused by few events of interest. The evidence for haemorrhage requiring transfusion or > 500ml of blood loss was very low quality; as with need for emergency care/hospital admission, the main reason evidence was downgraded was imprecision due to wide confidence intervals caused by few events of interest. The evidence for patient satisfaction was moderate quality; the only reason to downgrade the evidence for this outcome was risk of bias in the included study due to lack of comparability and inadequate follow-up. The evidence for complete abortion without the need for surgical intervention was very low quality; the reasons for downgrading of evidence being risk of bias in studies reporting this outcome and imprecision. The evidence for pain, diarrhoea and vomiting was very low to low quality; with the evidence mainly downgraded for imprecision due to wide confidence intervals and risk of bias in the studies reporting this outcome.</p></div><div id="ch7.s1.1.9.1.3"><h5>Benefits and harms</h5><p>Based on the evidence, it was unclear whether or not there was a clinically important difference in the rate of complete abortion without the need for surgical intervention between women undergoing home expulsion for medical abortion at gestational age ≤ 9<sup>+0</sup> weeks and 9<sup>+1</sup> to 12<sup>+0</sup> weeks. The evidence showed no higher risk of serious complications (such as the need for emergency care/hospitalisation and haemorrhage requiring transfusion or > 500ml of blood loss) and adverse events like vomiting and diarrhoea between women with gestational age ≤ 9<sup>+0</sup> and 9<sup>+1</sup> to 10<sup>+0</sup> weeks. There was no difference in the rate of women experiencing pain between those with gestational age ≤ 9<sup>+0</sup> weeks or 9<sup>+1</sup> to 12<sup>+0</sup> weeks. The evidence also showed that home expulsion for medical abortion was equally effective in terms of patient satisfaction when performed at ≤ 9<sup>+0</sup>or 9<sup>+1</sup> to 10<sup>+0</sup> weeks.</p><p>Based on this evidence, the committee agreed that the choice of medical abortion with expulsion at home can be safely offered up to and including 10<sup>+0</sup> weeks’ gestation. The committee noted that this recommendation is based on the evidence on the safety of home expulsion. Separate recommendations were made for women up to and including 9<sup>+6</sup> weeks gestation and women at 10<sup>+0</sup> weeks gestation due to the legal limit at which misoprostol can be taken at home, as specified in the Secretary of State’s approval order of December 2018 (The Abortion Act 1967 – Approval of a Class of Places). The committee also noted that whilst there was some evidence about women undergoing home expulsion up to and including 12<sup>+0</sup> weeks this was limited and very low quality. They therefore agreed this was not enough to support making a recommendation for clinical practice.</p><p>The committee noted that the evidence about women undergoing home expulsion up to and including 12<sup>+0</sup> weeks was from a single, very low quality study from outside the UK. They agreed that further research on home expulsion up to and including 12<sup>+0</sup> weeks in the United Kingdom setting would be beneficial to inform future practice and hence made a research recommendation (see <a href="#ch7.appl">Appendix L</a>).</p></div></div><div id="ch7.s1.1.9.2"><h5>Cost effectiveness and resource use</h5><p>A systematic review of the economic literature was conducted but no relevant studies were identified which were applicable to this review question and no economic analysis was conducted. The committee agreed that there was unlikely to be a significant resource impact from making these recommendations as expulsion at home after medical abortion is already standard practice, just at varying gestational ages. The committee considered that there could be potential cost savings from these recommendations due to less women needing to be admitted for their medical abortion. Also that there might be a shift away from surgical abortions at this gestational age which are more costly than medical abortions.</p></div><div id="ch7.s1.1.9.3"><h5>Other considerations</h5><p>The committee noted that at later gestational ages, the fetus becomes more visible during a medical abortion. Therefore the committee agreed that women who decide to have a medical abortion with expulsion at home at 10<sup>+0</sup> weeks would need to be made aware of this as it can be distressing if the woman is not expecting it. This was not considered a part of this review question. However, the committee discussed that the recommendations on information needs of women undergoing an abortion cover this issue.</p></div></div><div id="ch7.rl.r1"><h4>References</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="ch7.s1.1.ref1"><p id="p-105">
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<strong>Bracken 2014</strong>
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</p>Bracken, H., Dabash, R., Tsertsvadze, G., Posohova, S., Shah, M., Hajri, S., Mundle, S., Chelli, H., Zeramdini, D., Tsereteli, T., Platais, I., Winikoff, B., A two-pill sublingual misoprostol outpatient regimen following mifepristone for medical abortion through 70 days’ LMP: A prospective comparative open-label trial, Contraception, 89, 181–186, 2014 [<a href="https://pubmed.ncbi.nlm.nih.gov/24332431" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24332431</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch7.s1.1.ref2"><p id="p-106">
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<strong>Gomperts 2014</strong>
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</p>Gomperts, R., Van Der Vleuten, K., Jelinska, K., Da Costa, C. V., Gemzell-Danielsson, K., Kleiverda, G., Provision of medical abortion using telemedicine in Brazil, Contraception, 89, 129–133, 2014 [<a href="https://pubmed.ncbi.nlm.nih.gov/24314910" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24314910</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch7.s1.1.ref3"><p id="p-107">
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<strong>Sanhueza 2015</strong>
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</p>Sanhueza Smith, P., Pena, M., Dzuba, I. G., Martinez, M. L. G., Peraza, A. G. A., Bousieguez, M., Shochet, T., Winikoff, B., Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City, Reproductive health matters, Part S1. 22, 75–82, 2015 [<a href="https://pubmed.ncbi.nlm.nih.gov/25702071" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25702071</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch7.s1.1.ref4"><p id="p-108">
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<strong>Winikoff 2012</strong>
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</p>Winikoff, B., Dzuba, I. G., Chong, E., Goldberg, A. B., Steve Lichtenberg, E., Ball, C., Dean, G., Sacks, D., Crowden, W. A., Swica, Y., Extending outpatient medical abortion services through 70 days of gestational age, Obstetrics and Gynecology, 120, 1070–1076, 2012 [<a href="https://pubmed.ncbi.nlm.nih.gov/23090524" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23090524</span></a>]</div></p></li></ul></div></div></div><div id="appendixesappgroup7"><h2 id="_appendixesappgroup7_">Appendices</h2><div id="ch7.appa"><h3>Appendix A. Review protocols</h3><div id="ch7.appa.s1"><h4>Review protocol for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms??</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch7appatab1"><a href="/books/NBK561073/table/ch7.appa.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch7appatab1" rid-ob="figobch7appatab1"><img class="small-thumb" src="/books/NBK561073/table/ch7.appa.tab1/?report=thumb" src-large="/books/NBK561073/table/ch7.appa.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch7.appa.tab1"><a href="/books/NBK561073/table/ch7.appa.tab1/?report=objectonly" target="object" rid-ob="figobch7appatab1">Table</a></h4><p class="float-caption no_bottom_margin">Women who have requested a medical termination of pregnancy (using mifepristone + misoprostol) and expel their pregnancy at home (i.e., in a setting outside of a clinical facility) Exclusions:
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-Studies with indirect populations will not be considered</p></div></div></div></div><div id="ch7.appb"><h3>Appendix B. Literature search strategies</h3><div id="ch7.appb.s1"><h4>Literature search strategy for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>The search for this topic was last run on 19th November 2018 during the re-runs for this guideline.</p><p>
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<b>Database: Medline & Embase (Multifile)</b>
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</p><p>Last searched on <b>Embase Classic+Embase</b> 1947 to 2018 November 16, <b>Ovid MEDLINE(R) Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R)</b> 1946 to November 16, 2018</p><p id="ch7.appb.tab1"><a href="/books/NBK561073/table/ch7.appb.tab1/?report=objectonly" target="object" rid-ob="figobch7appbtab1" class="figpopup">Date of last search: 19<sup>th</sup> November 2018</a></p><p>
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<b>Database: Cochrane Library via Wiley Online</b>
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</p><p id="ch7.appb.tab2"><a href="/books/NBK561073/table/ch7.appb.tab2/?report=objectonly" target="object" rid-ob="figobch7appbtab2" class="figpopup">Date of last search: 19<sup>th</sup> November 2018</a></p><p>
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<b>Database: Cinahl Plus</b>
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</p><p id="ch7.appb.tab3"><a href="/books/NBK561073/table/ch7.appb.tab3/?report=objectonly" target="object" rid-ob="figobch7appbtab3" class="figpopup">Date of last search: 19<sup>th</sup> November 2018</a></p><p>
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<b>Database: Web of Science Core Collection</b>
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</p><p id="ch7.appb.tab4"><a href="/books/NBK561073/table/ch7.appb.tab4/?report=objectonly" target="object" rid-ob="figobch7appbtab4" class="figpopup">Timespan=1995-2018. Date of last search: 19<sup>th</sup> November 2018</a></p></div></div><div id="ch7.appc"><h3>Appendix C. Clinical evidence study selection</h3><div id="ch7.appc.s1"><h4>Clinical evidence study selection for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p id="ch7.appc.fig1"><a href="/books/NBK561073/figure/ch7.appc.fig1/?report=objectonly" target="object" rid-ob="figobch7appcfig1" class="figpopup">Figure 1. Study selection flow chart</a></p></div></div><div id="ch7.appd"><h3>Appendix D. Clinical evidence tables</h3><div id="ch7.appd.s1"><h4>Clinical evidence tables for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p id="ch7.appd.et1"><a href="/books/NBK561073/bin/ch7-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (363K)</span></p></div></div><div id="ch7.appe"><h3>Appendix E. Forest plots</h3><div id="ch7.appe.s1"><h4>Forest plots for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p id="ch7.appe.fig1"><a href="/books/NBK561073/figure/ch7.appe.fig1/?report=objectonly" target="object" rid-ob="figobch7appefig1" class="figpopup">Figure 2. Need for emergency care/hospital admission following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</a></p><p id="ch7.appe.fig2"><a href="/books/NBK561073/figure/ch7.appe.fig2/?report=objectonly" target="object" rid-ob="figobch7appefig2" class="figpopup">Figure 3. Haemorrhage >500ml/requiring blood transfusion following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</a></p><p id="ch7.appe.fig3"><a href="/books/NBK561073/figure/ch7.appe.fig3/?report=objectonly" target="object" rid-ob="figobch7appefig3" class="figpopup">Figure 4. Complete abortion without the need for surgical intervention following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</a></p><p id="ch7.appe.fig4"><a href="/books/NBK561073/figure/ch7.appe.fig4/?report=objectonly" target="object" rid-ob="figobch7appefig4" class="figpopup">Figure 5. Vomiting following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup>weeks’ gestation</a></p><p id="ch7.appe.fig5"><a href="/books/NBK561073/figure/ch7.appe.fig5/?report=objectonly" target="object" rid-ob="figobch7appefig5" class="figpopup">Figure 6. Pain following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</a></p><p id="ch7.appe.fig6"><a href="/books/NBK561073/figure/ch7.appe.fig6/?report=objectonly" target="object" rid-ob="figobch7appefig6" class="figpopup">Figure 7. Diarrhoea following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</a></p></div></div><div id="ch7.appf"><h3>Appendix F. GRADE tables</h3><div id="ch7.appf.s1"><h4>GRADE tables for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p id="ch7.appf.tab1"><a href="/books/NBK561073/table/ch7.appf.tab1/?report=objectonly" target="object" rid-ob="figobch7appftab1" class="figpopup">Table 3. Clinical evidence profile</a></p></div></div><div id="ch7.appg"><h3>Appendix G. Economic evidence study selection</h3><div id="ch7.appg.s1"><h4>Economic evidence for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="ch7.apph"><h3>Appendix H. Economic evidence tables</h3><div id="ch7.apph.s1"><h4>Economic evidence tables for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="ch7.appi"><h3>Appendix I. Economic evidence profiles</h3><div id="ch7.appi.s1"><h4>Economic evidence profiles for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="ch7.appj"><h3>Appendix J. Economic analysis</h3><div id="ch7.appj.s1"><h4>Economic analysis for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="ch7.appk"><h3>Appendix K. Excluded studies</h3><div id="ch7.appk.s1"><h4>Excluded studies for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><div id="ch7.appk.s1.1"><h5>Clinical studies</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch7appktab1"><a href="/books/NBK561073/table/ch7.appk.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch7appktab1" rid-ob="figobch7appktab1"><img class="small-thumb" src="/books/NBK561073/table/ch7.appk.tab1/?report=thumb" src-large="/books/NBK561073/table/ch7.appk.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch7.appk.tab1"><a href="/books/NBK561073/table/ch7.appk.tab1/?report=objectonly" target="object" rid-ob="figobch7appktab1">Table</a></h4></div></div></div><div id="ch7.appk.s1.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review. See <a href="/books/NBK561073/bin/bm2.pdf">supplementary material 2</a> for further information.</p></div></div></div><div id="ch7.appl"><h3>Appendix L. Research recommendations</h3><div id="ch7.appl.s1"><h4>Research recommendations for review question: For women who are having medical abortion, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</h4><p>For women who are having medical abortion between 10<sup>+1</sup> and 12<sup>+0</sup> weeks, what is the efficacy and acceptability of expulsion at home compared with expulsion in a clinical setting?</p><p>
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<b>Why this is important?</b>
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</p><p>Women after 10<sup>+0</sup> weeks of pregnancy who choose a medical method of abortion have traditionally been admitted to a medical facility to pass the pregnancy. In contrast, women who are at the same gestation but with a non-viable pregnancy may choose to have medical management at home. The medical regimen used between 10<sup>+1</sup> and 12<sup>+0</sup> weeks’ gestation is the same as that at less than 10 weeks except that additional dose of misoprostol may be required, and that bleeding/ pain may be greater and the acceptability of expulsion at home for women having a medical abortion at this gestation in the UK is not known.</p><p>There is some evidence from other countries where termination is restricted, that medical abortion at home up to 12 weeks is safe and acceptable. Considering the objective of the proposed research to compare the efficacy in two different settings, a randomised controlled trial design was considered to be suitable for address the research question.</p><p id="ch7.appl.tab1"><a href="/books/NBK561073/table/ch7.appl.tab1/?report=objectonly" target="object" rid-ob="figobch7appltab1" class="figpopup">Table 4. Research recommendation rationale</a></p><p id="ch7.appl.tab2"><a href="/books/NBK561073/table/ch7.appl.tab2/?report=objectonly" target="object" rid-ob="figobch7appltab2" class="figpopup">Table 5. Research recommendation modified PICO table</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews</p><p>These evidence reviews were developed by the National Guideline Alliance hosted by the Royal College of Obstetricians and Gynaecologists</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK561073</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/32813468" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">32813468</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch7tab1"><div id="ch7.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PPO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women who have requested a medical termination of pregnancy (using mifepristone + misoprostol) and expel their pregnancy at home (i.e., in a setting outside of a clinical facility)</td></tr><tr><th id="hd_b_ch7.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prognostic Factor</th><td headers="hd_b_ch7.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Prognostic factor:</b>
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</p>
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<p>Gestational age
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<ul id="l338"><li id="lt831" class="half_rhythm"><div><63 days (9<sup>+0</sup> weeks),</div></li><li id="lt832" class="half_rhythm"><div>64 to 70 days (9<sup>+1</sup> to 10<sup>+0</sup> weeks),</div></li><li id="lt833" class="half_rhythm"><div>>71 days (10<sup>+1</sup> weeks)</div></li></ul></p>
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</td></tr><tr><th id="hd_b_ch7.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_ch7.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical outcomes:</b>
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<ul id="l339"><li id="lt834" class="half_rhythm"><div>Need for emergency care/hospital admission</div></li><li id="lt835" class="half_rhythm"><div>Haemorrhage requiring blood transfusion or > 500ml of blood loss</div></li><li id="lt836" class="half_rhythm"><div>Patient satisfaction</div></li></ul>
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<b>Important outcomes:</b>
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<ul id="l340"><li id="lt837" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt838" class="half_rhythm"><div>Vomiting</div></li><li id="lt839" class="half_rhythm"><div>Pain</div></li><li id="lt840" class="half_rhythm"><div>Diarrhoea</div></li></ul></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch7tab2"><div id="ch7.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study and setting</th><th id="hd_h_ch7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_ch7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Prognostic factor</th><th id="hd_h_ch7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>
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</p>
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<p>Prospective cohort study</p>
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<p>Multi country (Georgia, India, Tunisia, Ukraine)</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=703</p>
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<p>Women 18 years or older, in good health with pregnancies greater than 56 days and less than 71 days from LMP based on ultrasound and/or clinical exam and history</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Medical abortion regimen:</b> 200 mg oral mifepristone and 400 micrograms (mcg) sublingual misoprostol</p>
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<p>Gestational age:</p>
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<p>≤ 9<sup>+0</sup> weeks versus 9+1 to10+0 weeks</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l341"><li id="lt841" class="half_rhythm"><div>Need for emergency care/hospital admission</div></li><li id="lt842" class="half_rhythm"><div>Haemorrhage requiring blood transfusion or > 500ml of blood loss</div></li><li id="lt843" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt844" class="half_rhythm"><div>Vomiting</div></li><li id="lt845" class="half_rhythm"><div>Pain</div></li><li id="lt846" class="half_rhythm"><div>Diarrhoea</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>
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</p>
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<p>Retrospective cohort study</p>
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<p>Brazil</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=307; out of which 278 had pregnancies less than or equal to 9 weeks, or 10-12 weeks and were included in the review</p>
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<p>Women from Brazil who contacted Women on Web from January to December 2011 and performed a medical abortion provided through Women on Web’s telemedicine service.</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Medical abortion regimen</b>: 200 mg mifepristone and 800 mcg sublingual misoprostol after 24 hours, followed by 400 mcg sublingual misoprostol after 4 hours.</p>
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<p>Gestational age:</p>
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<p>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 12<sup>+0</sup> weeks</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l342"><li id="lt847" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt848" class="half_rhythm"><div>Pain</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>
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</p>
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<p>Prospective cohort study</p>
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<p>Mexico</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=960</p>
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<p>Women with pregnancies up to 70 days LMP eligible for medical abortion</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Medical abortion regimen</b>: 200 mg mifepristone followed by 800 mcg misoprostol 24 to 48 hours later</p>
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<p>Gestational age:</p>
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<p>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to10<sup>+0</sup> weeks</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l343"><li id="lt849" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt850" class="half_rhythm"><div>Vomiting</div></li><li id="lt851" class="half_rhythm"><div>Pain</div></li><li id="lt852" class="half_rhythm"><div>Diarrhoea</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>
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</p>
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<p>Prospective cohort study</p>
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<p>United States</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>n=629</p>
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<p>Women 18 years old and older with confirmed intrauterine pregnancy 57 through 70 days from LMP, based on routine ultrasound and able to speak and read English or Spanish.</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Medical abortion regimen:</b> 200 mg mifepristone and 800 mcg buccal misoprostol</p>
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<p>Gestational age:</p>
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<p>≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to10<sup>+0</sup> weeks</p>
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</td><td headers="hd_h_ch7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l344"><li id="lt853" class="half_rhythm"><div>Need for emergency care</div></li><li id="lt854" class="half_rhythm"><div>Haemorrhage requiring blood transfusion or > 500ml of blood loss</div></li><li id="lt855" class="half_rhythm"><div>Patient satisfaction (satisfied or very satisfied)</div></li><li id="lt856" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt857" class="half_rhythm"><div>Vomiting</div></li><li id="lt858" class="half_rhythm"><div>Diarrhoea</div></li></ul>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">LMP: Last menstrual period; mcg: micrograms</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch7appatab1"><div id="ch7.appa.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appa.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a></th><th id="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question in SCOPE</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For women who are having medical termination of pregnancy, what gestational limit for expulsion at home offers the best balance of benefits and harms?</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question in guideline</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For women who are having medical termination of pregnancy, what gestational limit for expulsion at home (i.e., setting outside of clinical facility) offers the best balance of benefits and harms?</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prognostic review</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To determine what gestational limit offers the best balance of benefits and harms for home (i.e., setting outside of clinical facility) expulsion of pregnancy.</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Women who have requested a medical termination of pregnancy (using mifepristone + misoprostol) and expel their pregnancy at home (i.e., in a setting outside of a clinical facility)</p>
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<p>Exclusions:
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<dl id="l345" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt859"><p class="no_top_margin">Studies with indirect populations will not be considered</p></dd></dl></dl></p>
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</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – prognostic factor(s)</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Prognostic factor:</p>
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<p>Gestational age:
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|
<dl id="l346" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt860"><p class="no_top_margin"><63 days (9+0 weeks)</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt861"><p class="no_top_margin">64 to 70 days (9+1 to 10+0 weeks)</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt862"><p class="no_top_margin">>71 days (10+1 weeks)</p></dd></dl></dl></p>
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|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confounding factors</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Analysis should adjust for important confounding factors, as a minimum include: None applicable</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical outcomes:</b>
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<ul id="l347"><li id="lt863" class="half_rhythm"><div>Need for emergency care/hospital admission</div></li><li id="lt864" class="half_rhythm"><div>Haemorrhage requiring blood transfusion or > 500ml of blood loss</div></li><li id="lt865" class="half_rhythm"><div>Patient satisfaction</div></li></ul>
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<b>Important outcomes:</b>
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<ul id="l348"><li id="lt866" class="half_rhythm"><div>Complete abortion without the need for surgical intervention</div></li><li id="lt867" class="half_rhythm"><div>Vomiting</div></li><li id="lt868" class="half_rhythm"><div>Pain</div></li><li id="lt869" class="half_rhythm"><div>Diarrhoea</div></li></ul></td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<dl id="l349" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt870"><p class="no_top_margin">Systematic reviews of prospective and/or retrospective cohort studies</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt871"><p class="no_top_margin">Prospective cohort studies n≥100 per gestational age group</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt872"><p class="no_top_margin">Retrospective cohort studies n≥100 per gestational age group</p></dd></dl></dl>
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</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inclusion:
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<dl id="l350" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt873"><p class="no_top_margin">English-language</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt874"><p class="no_top_margin">Studies conducted from 1995 (see below)</p></dd></dl></dl></td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Stratified analyses based on the following sub-groups of women, where possible:</p>
|
|
<p>Medical conditions:
|
|
<dl id="l351" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt875"><p class="no_top_margin">Complex pre-existing medical conditions</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt876"><p class="no_top_margin">No complex pre-existing medical conditions</p></dd></dl></dl>
|
|
Vulnerability of women:
|
|
<dl id="l352" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt877"><p class="no_top_margin">Vulnerable (including adolescents)</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt878"><p class="no_top_margin">Non-vulnerable</p></dd></dl></dl>
|
|
Language of women:
|
|
<dl id="l353" class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd id="lt879"><p class="no_top_margin">English speaking</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd id="lt880"><p class="no_top_margin">Non-English speaking</p></dd></dl></dl></p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Dual sifting will be undertaken for this question using NGA STAR software, with resolution of discrepancies in discussion with the senior reviewer if necessary.</p>
|
|
<p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer.</p>
|
|
<p>Quality control will be performed by the senior systematic reviewer.</p>
|
|
<p>Dual data extraction will not be performed for this question.</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pairwise meta-analyses will be performed using Cochrane Review Manager (RevMan5).</p>
|
|
<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
|
|
<p>NGA STAR software will be used for study sifting, data extraction, recording quality assessment using checklists and generating bibliographies/citations,</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase</p>
|
|
<p>Limits (e.g. date, study design):</p>
|
|
<p>Apply standard animal/non-English language exclusion</p>
|
|
<p>Dates: from 1995</p>
|
|
<p>Only studies conducted from 1995 onwards will be considered for this review question, as home expulsion for gestational ages above 63 days was not done in clinical practice before 1995.</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not an update</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the guideline in development web site.</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch7.appb">appendix B</a></td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch7.appd">appendix D</a> (clinical evidence tables) or <a href="#ch7.apph">H</a> (economic evidence tables).</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch7.appd">appendix D</a> (clinical evidence tables) or <a href="#ch7.apph">H</a> (economic evidence tables).</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Standard study checklists will be used to critically appraise individual studies. For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></p>
|
|
<p>The risk of bias across all available evidence will be evaluated for each outcome using an adaptation of the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a></p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></p>
|
|
<p>Meta-analyses will be conducted for this prognostic review only if the same covariates are included in the analyses (preferably only gestational age), the same analytical methods are, or can be, adopted, and the populations assessed are suitably similar. In all other cases, the results will reported separately.</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Where possible, univariate risk ratios will be calculated or reported, with their 95% confidence interval. However if risk ratios cannot be calculated or are not reported, odds ratios or hazard ratios will be reported (depending on what the included studies reported). The results will be plotted with their 95% confidence interval in forest plots in Review Manager, and if possible (see cell above), the results will be pooled. The forest plots will be used to visually see the studies alongside each other and to explore similarities and differences between them.</p>
|
|
<p>Synthesis of data:</p>
|
|
<p>Pairwise meta-analysis will be conducted where appropriate for all outcomes.</p>
|
|
<p>When meta-analysing continuous data, change scores will be pooled in preference to final scores.</p>
|
|
<p>For details regarding inconsistency, please see the <a href="/books/NBK561073/bin/bm1.pdf">methods</a> chapter</p>
|
|
<p>Minimally important differences:</p>
|
|
<p>‘Need for emergency care/hospital admission’ and ‘haemorrhage requiring transfusion or > 500ml of blood loss’: Statistical significance</p>
|
|
<p>Complete abortion without the need for surgical intervention: 3% (with the upper end of the 95% CI ≤ 5%)</p>
|
|
<p>For the remaining outcomes default values will be used: 0.8 and 1.25 for dichotomous outcomes; 0.5 times SD (for the control group) for continuous outcomes.</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of Developing NICE guidelines: the manual.</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review.</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>A multidisciplinary committee developed the guideline. The committee was convened by The National Guideline Alliance and chaired by Profession Iain Cameron in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
|
|
<p>Staff from The National Guideline Alliance will undertake systematic literature searches, appraise the evidence, conduct meta-analysis and cost-effectiveness analysis where appropriate, and draft the guideline in collaboration with the committee. For details please see the <a href="/books/NBK561073/bin/bm1.pdf">methods</a> chapter.</p>
|
|
</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds The National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England</td></tr><tr><td headers="hd_h_ch7.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch7.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">GRADE: Grading of Recommendations Assessment, Development and Evaluation; NHS: National Health Service; NICE: National Institute for Health and Care Excellence; NGA: National Guideline Alliance; SD: standard deviation</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch7appbtab1"><div id="ch7.appb.tab1" class="table"><h3><span class="title">Date of last search: 19<sup>th</sup> November 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp abortion/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp pregnancy termination/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Abortion, Induced/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abortion Applicants/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Abortion, Spontaneous/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Abortion, Criminal/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aborted fetus/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">fetus death/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">abortion.mp.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(abort$ or postabort$ or preabort$).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((f?etal$ or f?etus$ or gestat$ or midtrimester$ or pregnan$ or prenatal$ or pre natal$ or trimester$) and terminat$).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((f?etal$ or f?etus$) adj loss$).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((gestat$ or midtrimester$ or pregnan$ or prenatal$ or pre natal$ or trimester$) adj3 loss$).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((elective$ or threaten$ or voluntar$) adj3 interrupt$) and pregnan$).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Outpatients/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(*outpatient care/ or *outpatient/) use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ambulatory Care/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ambulatory care/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Self Administration/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">drug self administration/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp home/ or home care/) use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">home monitoring/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“at home”.tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(home$ adj3 (base$ or phase$ or use$ or administrat$ or manage$ or abortion$ or termination$)).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((misoprostol$ or mifepriston$) adj3 (self-administer$ or home$ or outpatient$)).tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 and 27</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mifepristone/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mifepristone/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mifepriston$ or mifeprex$ or mifegyn$ or ru-486$ or ru486$ or ru-38486$ or ru38486$).mp.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 or 30 or 31</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Misoprostol/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">misoprostol/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(misoprostol$ or cytotec$ or arthrotec$ or oxaprost$ or cyprostol$ or mibetec$ or prostokos$ or misotrol$).mp.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 or 34 or 35</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gestational Age/ use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">gestational age/ use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">gestation$.tw.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37 or 38 or 39</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 and 32 and 36 and 40</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 or 41</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 42 to english language</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 43 to yr="1995 -Current”</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45 or 46 or 47 or 48 or 49 or 50 or 51 or 52</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 not 54</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55 or 56 or 57 or 58 or 59 or 60 or 61</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63 or 64 or 65 or 66 or 67</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68 not 69</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70 or 71 or 72 or 73 or 74 or 75 or 76 or 77</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62 use ppez</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78 use emczd</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79 or 80</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44 and 81</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44 not 82</td></tr><tr><td headers="hd_h_ch7.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84</td><td headers="hd_h_ch7.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">remove duplicates from 83</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch7appbtab2"><div id="ch7.appb.tab2" class="table"><h3><span class="title">Date of last search: 19<sup>th</sup> November 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appb.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Abortion, Induced] explode all trees</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Abortion Applicants] explode all trees</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Abortion, Spontaneous] explode all trees</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Abortion, Criminal] explode all trees</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Aborted Fetus] explode all trees</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“abortion":ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(abort* or postabort* or preabort*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fetal* or fetus* or foetal* or foetus* or gestat* or midtrimester* or pregnan* or prenatal* or pre natal* or trimester*) and terminat*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fetal* or fetus* or foetal* or foetus*) next loss*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((gestat* or midtrimester* or pregnan* or prenatal* or pre natal* or trimester*) near/3 loss*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((elective* or threaten* or voluntar*) near/3 interrupt*) and pregnan*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Outpatients] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Ambulatory Care] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Self Administration] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“at home”:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(home* near/3 (base* or phase* or use* or administrat* or manage* or abortion* or termination*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((misoprostol* or mifepriston*) near/3 (self-administer* or home* or outpatient*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13 or #14 or #15 or #16 or #17 or #18</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12 and #19</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Mifepristone] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mifepriston* or mifeprex* or mifegyn* or ru-486* or ru486* or ru-38486* or ru38486*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Misoprostol] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(misoprostol* or cytotec* or arthrotec* or oxaprost* or cyprostol* or mibetec* or prostokos* or misotrol*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gestational Age] this term only</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">gestation*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((#21 or #22) and (#23 or #24) and (#25 or #26))</td></tr><tr><td headers="hd_h_ch7.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_ch7.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20 or #27</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch7appbtab3"><div id="ch7.appb.tab3" class="table"><h3><span class="title">Date of last search: 19<sup>th</sup> November 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appb.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S24</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S23 Limiters - Publication Year: 1995-2018; English Language</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S23</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S12 OR S22</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S22</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S4 AND S15 AND S18 AND S21</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S21</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S19 OR S20</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S20</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (gestation*) OR AB (gestation*)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S19</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Gestational Age”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S18</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S16 OR S17</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S17</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (misoprostol* or cytotec* or arthrotec* or oxaprost* or cyprostol* or mibetec* or prostokos* or misotrol*) OR AB (misoprostol* or cytotec* or arthrotec* or oxaprost* or cyprostol* or mibetec* or prostokos* or misotrol*)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S16</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Misoprostol”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S15</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S13 OR S14</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S14</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (mifepriston* or mifeprex* or mifegyn* or ru-486* or ru486* or ru-38486* or ru38486*) OR AB (mifepriston* or mifeprex* or mifegyn* or ru-486* or ru486* or ru-38486* or ru38486*)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S13</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Mifepristone”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S12</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S4 AND S11</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S11</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S5 OR S6 OR S7 OR S8 OR S9 OR S10</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S10</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI ((misoprostol* or mifepriston*) N3 (self-administer* or home* or outpatient*)) OR AB ((misoprostol* or mifepriston*) N3 (self-administer* or home* or outpatient*))</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S9</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (home* N3 (base* or phase* or use* or administrat* or manage* or abortion* or termination*)) OR AB (home* N3 (base* or phase* or use* or administrat* or manage* or abortion* or termination*))</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S8</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (“at home”) OR AB (“at home”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S7</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Self Administration”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S6</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Ambulatory Care”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S5</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MM “Outpatients”)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S4</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S1 OR S2 OR S3</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S3</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI ((f?etal* or f?etus* or gestat* or midtrimester* or pregnan* or prenatal* or pre natal* or trimester*) and terminat*) OR AB ((f?etal* or f?etus* or gestat* or midtrimester* or pregnan* or prenatal* or pre natal* or trimester*) and terminat*)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S2</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TI (abort* or postabort* or preabort*) OR AB (abort* or postabort* or preabort*)</td></tr><tr><td headers="hd_h_ch7.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">S1</td><td headers="hd_h_ch7.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(MH “Abortion, Habitual”) OR (MH “Abortion, Criminal”) OR (MH “Abortion, Spontaneous”) OR (MH “Abortion, Incomplete”)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch7appbtab4"><div id="ch7.appb.tab4" class="table"><h3><span class="title">Timespan=1995-2018. Date of last search: 19<sup>th</sup> November 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appb.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#</th><th id="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 14</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#13 Refined by: [excluding] DOCUMENT TYPES: (NEWS ITEM OR EDITORIAL MATERIAL OR LETTER)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 13</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#12 OR #8</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 12</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#11 AND #10 AND #9 AND #3</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 11</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(gestation*)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 10</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(misoprostol* or cytotec* or arthrotec* or oxaprost* or cyprostol* or mibetec* or prostokos* or misotrol*)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 9</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(mifepristone* or mifeprex* or mifegyn* or ru-486* or ru486* or ru-38486* or ru38486*)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 8</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#7 AND #3</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 7</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#4 OR #5 OR #6</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 6</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(“at home”)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 5</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=((misoprostol* or mifepriston*) NEAR/3 (self-administer* or home* or outpatient*))</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 4</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(home* NEAR/3 (base* or phase* or use* or administrat* or manage* or abortion* or termination*))</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 3</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#2 OR #1</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 2</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=((f?etal* or f?etus* or gestat* or midtrimester* or pregnan* or prenatal* or pre natal* or trimester*) and terminat*)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr><tr><td headers="hd_h_ch7.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"># 1</td><td headers="hd_h_ch7.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>TS=(abort* or postabort* or preabort*)</p>
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<p>Indexes=SCI-EXPANDED, SSCI Timespan=1995-2018</p>
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</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobch7appcfig1"><div id="ch7.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Study%20selection%20flow%20chart.&p=BOOKS&id=561073_ch7appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appcf1.jpg" alt="Figure 1. Study selection flow chart." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Study selection flow chart</span></h3></div></article><article data-type="fig" id="figobch7appefig1"><div id="ch7.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Need%20for%20emergency%20care%2Fhospital%20admission%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2010%2B0%20weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef1.jpg" alt="Figure 2. Need for emergency care/hospital admission following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 10+0 weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Need for emergency care/hospital admission following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</span></h3></div></article><article data-type="fig" id="figobch7appefig2"><div id="ch7.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Haemorrhage%20%3E500ml%2Frequiring%20blood%20transfusion%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2010%2B0%20weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef2.jpg" alt="Figure 3. Haemorrhage >500ml/requiring blood transfusion following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 10+0 weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Haemorrhage >500ml/requiring blood transfusion following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</span></h3></div></article><article data-type="fig" id="figobch7appefig3"><div id="ch7.appe.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20Complete%20abortion%20without%20the%20need%20for%20surgical%20intervention%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2012%2B0%20weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef3.jpg" alt="Figure 4. Complete abortion without the need for surgical intervention following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 12+0 weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Complete abortion without the need for surgical intervention following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</span></h3></div></article><article data-type="fig" id="figobch7appefig4"><div id="ch7.appe.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20Vomiting%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2010%2B0weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef4.jpg" alt="Figure 5. Vomiting following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 10+0weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Vomiting following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup>weeks’ gestation</span></h3></div></article><article data-type="fig" id="figobch7appefig5"><div id="ch7.appe.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Pain%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2012%2B0%20weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef5.jpg" alt="Figure 6. Pain following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 12+0 weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Pain following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation</span></h3></div></article><article data-type="fig" id="figobch7appefig6"><div id="ch7.appe.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Diarrhoea%20following%20expulsion%20at%20home%20at%20%02264%209%2B0%20weeks%20compared%20to%209%2B1%20to%2010%2B0%20weeks%02019%20gestation.&p=BOOKS&id=561073_ch7appef6.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561073/bin/ch7appef6.jpg" alt="Figure 7. Diarrhoea following expulsion at home at ≤ 9+0 weeks compared to 9+1 to 10+0 weeks’ gestation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Diarrhoea following expulsion at home at ≤ 9<sup>+0</sup> weeks compared to 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation</span></h3></div></article><article data-type="table-wrap" id="figobch7appftab1"><div id="ch7.appf.tab1" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence profile</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch7.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:bottom;">Quality assessment</th><th id="hd_h_ch7.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">No of patients</th><th id="hd_h_ch7.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Effect</th><th id="hd_h_ch7.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch7.appf.tab1_1_1_1_4" style="text-align:left;vertical-align:bottom;">Quality</th><th id="hd_h_ch7.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch7.appf.tab1_1_1_1_5" style="text-align:left;vertical-align:bottom;">Importance</th></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No of studies</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Design</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of bias</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inconsistency</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Indirectness</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Imprecision</th><th headers="hd_h_ch7.appf.tab1_1_1_1_1" id="hd_h_ch7.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Other considerations</th><th headers="hd_h_ch7.appf.tab1_1_1_1_2" id="hd_h_ch7.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">≤ 9 weeks</th><th headers="hd_h_ch7.appf.tab1_1_1_1_2" id="hd_h_ch7.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">> 9 weeks</th><th headers="hd_h_ch7.appf.tab1_1_1_1_3" id="hd_h_ch7.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Relative (95% CI)</th><th headers="hd_h_ch7.appf.tab1_1_1_1_3" id="hd_h_ch7.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Need for emergency care/hospital admission</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>2</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14/707</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15/625</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.86 (0.42 to 1.77)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 fewer per 1000 (from 14 fewer to 18 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Haemorrhage requiring transfusion or > 500ml of blood loss</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>2</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3/707</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2/625</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.34 (0.23 to 7.94)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 more per 1000 (from 2 fewer to 22 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Patient satisfaction (satisfied or very satisfied)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>3</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">284/325</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">268/304</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.99 (0.94 to 1.05)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 fewer per 1000 (from 53 fewer to 44 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MODERATE</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Complete abortion without the need for surgical intervention (Pooled results: ≤ 9 weeks versus >9 weeks’ gestation)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>; <a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>4</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>5</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1590/1726</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">771/844</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.02 (0.99 to 1.04)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 more per 1000 (from 9 fewer to 37 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Complete abortion without the need for surgical intervention (Subgroup: ≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>5</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1427/1519</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">712/773</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.02 (1.00 to 1.05)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 more per 1000 (from 0 more to 46 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Complete abortion without the need for surgical intervention</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 (<a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>6</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>5</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">163/207</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59/71</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.95 (0.83 to 1.08)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42 fewer per 1000 (from 141 fewer to 66 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_13_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Vomiting</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>7</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">350/1510</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">232/761</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.8 (0.69 to 0.93)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61 fewer per 1000 (from 21 fewer to 95 fewer)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_15_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Pain (Pooled results: ≤ 9 weeks versus >9 weeks’ gestation)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>; <a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>4</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>8</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">528/1401</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">239/540</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.91 (0.81 to 1.03)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40 fewer per 1000 (from 84 fewer to 13 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_17_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Pain (Subgroup: ≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 10<sup>+0</sup> weeks’ gestation)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>8</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">523/1194</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">238/469</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.91 (0.81 to 1.02)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46 fewer per 1000 (from 96 fewer to 10 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_19_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Pain (Subgroup: ≤ 9<sup>+0</sup> weeks versus 9<sup>+1</sup> to 12<sup>+0</sup> weeks’ gestation)</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 (<a class="bibr" href="#ch7.s1.1.ref2" rid="ch7.s1.1.ref2">Gomperts 2014</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>6</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>9</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5/207</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1/71</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.71 (0.20 to 14.43)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 more per 1000 (from 11 fewer to 189 more)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_h_ch7.appf.tab1_1_1_2_3 hd_h_ch7.appf.tab1_1_1_2_4 hd_h_ch7.appf.tab1_1_1_2_5 hd_h_ch7.appf.tab1_1_1_2_6 hd_h_ch7.appf.tab1_1_1_2_7 hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_h_ch7.appf.tab1_1_1_2_9 hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_h_ch7.appf.tab1_1_1_2_11 hd_h_ch7.appf.tab1_1_1_1_4 hd_h_ch7.appf.tab1_1_1_1_5" id="hd_b_ch7.appf.tab1_1_1_21_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Diarrhoea</th></tr><tr><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_1 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 (<a class="bibr" href="#ch7.s1.1.ref1" rid="ch7.s1.1.ref1">Bracken 2014</a>; <a class="bibr" href="#ch7.s1.1.ref4" rid="ch7.s1.1.ref4">Winikoff 2012</a>; <a class="bibr" href="#ch7.s1.1.ref3" rid="ch7.s1.1.ref3">Sanhueza 2015</a>)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_2 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohort studies</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_3 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>1</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_4 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious inconsistency</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_5 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_6 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>7</sup></td><td headers="hd_h_ch7.appf.tab1_1_1_1_1 hd_h_ch7.appf.tab1_1_1_2_7 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_8 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">442/1510</td><td headers="hd_h_ch7.appf.tab1_1_1_1_2 hd_h_ch7.appf.tab1_1_1_2_9 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">169/762</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_10 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.85 (0.73 to 0.99)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_3 hd_h_ch7.appf.tab1_1_1_2_11 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 fewer per 1000 (from 2 fewer to 60 fewer)</td><td headers="hd_h_ch7.appf.tab1_1_1_1_4 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td><td headers="hd_h_ch7.appf.tab1_1_1_1_5 hd_b_ch7.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CI: confidence interval; MID: minimally important difference; RR: risk ratio</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch7.appf.tab1_1"><p class="no_margin">Downgraded by 1 level for serious risk of bias as some of the included studies were at high risk of bias as they did not control or adjust for confounding factors, and there was no description of those lost to follow-up</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch7.appf.tab1_2"><p class="no_margin">The MID for this outcome is statistical significance, and the imprecision ratings were undertaken on that basis by using the optimum information size so that if the total event rate ≥300, then the quality was not downgraded, if the event rate = 150-299, then the quality was downgraded by 1 level and if the event rate <150, then the quality was downgraded by 2 levels</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch7.appf.tab1_3"><p class="no_margin">Downgraded by 1 level for serious risk of bias as the included study was at high risk of bias as it did not control or adjust for confounding factors, and there was no description of those lost to follow-up</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch7.appf.tab1_4"><p class="no_margin">Downgraded by 2 levels for very serious risk of bias as some of the included studies did not control or adjust for confounding factors, had self-reported period of gestation and provided no description of those lost to follow-up</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="ch7.appf.tab1_5"><p class="no_margin">The MID for this outcome is 3%, and the imprecision ratings were undertaken on that basis by using the absolute effect estimates so that if the CI crosses 30 fewer (3% of 1000) or 30 more, then the quality was downgraded by 1 level. If the CI crosses both, then the quality was downgraded by 2 levels</p></div></dd></dl><dl class="bkr_refwrap"><dt>6</dt><dd><div id="ch7.appf.tab1_6"><p class="no_margin">Downgraded by 2 levels for very serious risk of bias as the included study did not control or adjust for confounding factors, had self-reported period of gestation and provided no description of those lost to follow-up</p></div></dd></dl><dl class="bkr_refwrap"><dt>7</dt><dd><div id="ch7.appf.tab1_7"><p class="no_margin">Downgraded by 1 level for serious imprecision as the 95% CI crosses 1 MID</p></div></dd></dl><dl class="bkr_refwrap"><dt>8</dt><dd><div id="ch7.appf.tab1_8"><p class="no_margin">Downgraded by 1 level for serious indirectness as 1 of the included studies reports the need for nonsteroidal anti-inflammatory drugs for pain management instead of pain as an outcome</p></div></dd></dl><dl class="bkr_refwrap"><dt>9</dt><dd><div id="ch7.appf.tab1_9"><p class="no_margin">Downgraded by 2 levels for serious imprecision as the 95% CI crosses 2 MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch7appktab1"><div id="ch7.appk.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appk.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appk.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abbas, D., Chong, E., Raymond, E. G., Outpatient medical abortion is safe and effective through 70 days gestation, Contraception, 92, 197-199, 2015</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review article</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aiken, A. R. A., Gomperts, R., Trussell, J., Experiences and characteristics of women seeking and completing at-home medical termination of pregnancy through online telemedicine in Ireland and Northern Ireland: a population-based analysis, BJOG: An International Journal of Obstetrics and Gynaecology, 124, 1208-1215, 2017</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestation age less than 9 weeks were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Akin, A., Blum, J., Ozalp, S., Onderoglu, L., Kirca, U., Bilgili, N., Kocoglu, G., Philip, N., Winikoff, B., Results and lessons learned from a small medical abortion clinical study in Turkey, Contraception, 70, 401-406, 2004</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestation age less than 56 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ashok, P. W., Templeton, A., Wagaarachchi, P. T., Flett, G. M. M., Factors affecting the outcome of early medical abortion: A review of 4132 consecutive cases, BJOG: An International Journal of Obstetrics and Gynaecology, 109, 1281-1289, 2002</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 63 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aubeny,E., Chatellier,G., A randomized comparison of mifepristone and self-administered oral or vaginal misoprostol for early abortion, European Journal of Contraception and Reproductive Health Care, 5, 171-176, 2000</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestation age less than 49 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bartz,D., Goldberg,A., Medication abortion, Clinical Obstetrics and Gynecology, 52, 140-150, 2009</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review article</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Basu, R., Gundlach, T., Tasker, M., Mifepristone and misoprostol for medical termination of pregnancy: The effectiveness of a flexible regimen, Journal of Family Planning and Reproductive Health Care, 29, 139-141, 2003</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital based abortion</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bebbington, M. W., Kent, N., Lim, K., Gagnon, A., Delisle, M. R., Tessier, F., Wilson, R. A., Ngai, S. W., Vaginal misoprostol induced midtrimester termination of pregnancy more quickly than oral misoprostol, Evidence-based Obstetrics and Gynecology, 5, 79-80, 2003</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital based abortion</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Beckman, L. J., Harvey, S. M., Experience and acceptability of medical abortion with mifepristone and misoprostol among U.S. women, Womens Health Issues, 7, 253-62, 1997</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison of outcomes based on gestation age not available</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Blum, J., Raghavan, S., Dabash, R., Ngoc, N. T. N., Chelli, H., Hajri, S., Conkling, K., Winikoff, B., Comparison of misoprostol-only and combined mifepristone-misoprostol regimens for home-based early medical abortion in Tunisia and Vietnam, International Journal of Gynecology and Obstetrics, 118, 166-171, 2012</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 63 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Boersma, A. A., Meyboom-De Jong, B., Kleiverda, G., Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curacao, European Journal of Contraception and Reproductive Health Care, 16, 61-66, 2011</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 participants in each arm of comparison groups</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Carbonell, J. L. L., Varela, L., Velazco, A., Fernandez, C., The use of misoprostol for termination of early pregnancy, Contraception, 55, 165-168, 1997</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not include mifepristone and misoprostol regimen</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chen, M. J., Creinin, M. D., Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review, Obstet Gynecol, 126, 12-21, 2015</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevant studies from this systematic review are included individually in the current review</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clark, W. H., Hassoun, D., Gemzell-Danielsson, K., Fiala, C., Winikoff, B., Home use of two doses of misoprostol after mifepristone for medical abortion: A pilot study in Sweden and France, European Journal of Contraception and Reproductive Health Care, 10, 184-191, 2005</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 49 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conkling, K., Karki, C., Tuladhar, H., Bracken, H., Winikoff, B., A prospective open-label study of home use of mifepristone for medical abortion in Nepal, International Journal of Gynecology and Obstetrics, 128, 220-223, 2015</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes not reported separately for those more than 9 weeks’ gestation</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dzuba, I., Chong, E., Adams, M. C., Ali, R., Rzayeva, G., Hannum, C., Lichtenberg, E. S., Nhu Ngoc, N. T., Patel, A., Sanhueza, P., Tsertsvadze, G., Winikoff, B., Outpatient mifepristone-misoprostol medical abortion through 77 days of gestation, European Journal of Contraception and Reproductive Health Care, 21, 62, 2016</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text is an abstract. Further details about the study data is not available.</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Esen, Umo Ita, Early medical abortion at home…Cameron S, Glasier A, Dewart H, et al. Women’s experiences of the final stage of early medical abortion at home: results of a pilot survey. J Fam Plann Reprod Health Care 2010;36:213-216, 37, 123-124, 2011</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Letter to editor</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gallo, M. F., Cahill, S., Castleman, L., Mitchell, E. M. H., A systematic review of more than one dose of misoprostol after mifepristone for abortion up to 10 weeks of gestation, Contraception, 74, 36-41, 2006</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All included studies in this systematic review have gestational period less than 9 weeks</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gomperts, R., Jelinska, K., Davies, S., Gemzell-Danielsson, K., Kleiverda, G., Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services, International Journal of Gynecology and Obstetrics, 2), S230-S231, 2009</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text is an abstract. Further details about the study data is not available.</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gomperts, R., Kleiverda, G., Gemzell, K., The effectiveness of home medical abortions provided through telemedicine, International Journal of Gynecology and Obstetrics, 5), E299-E300, 2015</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text is an abstract. Further details about the study data is not available.</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Guengant, J. P., Bangou, J., Elul, B., Ellertson, C., Mifepristone-misoprostol medical abortion: Home administration of misoprostol in Guadeloupe, Contraception, 60, 167-172, 1999</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 49 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hamoda, H., Ashok, P. W., Flett, G. M. M., Templeton, A., A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation, BJOG: An International Journal of Obstetrics and Gynaecology, 112, 1102-1108, 2005</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Segregated data for gestation groups of interest was not available.</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jain, J. K., Dutton, C., Harwood, B., Meckstroth, K. R., Mishell Jr, D. R., A prospective randomized, double-blinded, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy, Human Reproduction, 17, 1477-1482, 2002</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 56 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kawonga, M., Blanchard, K., Cooper, D., Cullingworth, L., Dickson, K., Harrison, T., Von Mollendorf, C., Winikoff, B., Integrating medical abortion into safe abortion services: Experience from three pilot sites in South Africa, Journal of Family Planning and Reproductive Health Care, 34, 159-164, 2008</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 56 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kiran, U., Amin, P., Penketh, R. J., Self-administration of misoprostol for termination of pregnancy: Safety and efficacy, Journal of obstetrics and gynaecology, 24, 155-156, 2004</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only 8 participants were in the more than 9 weeks’ gestation period group</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kiran, U., Amin, P., Penketh, R. J., Self-administration of vaginal misoprostol after mifepristone for termination of pregnancy: Patient acceptability, Journal of obstetrics and gynaecology, 26, 679-681, 2006</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 participants in each comparison group</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mention, J. E., Lanta, S., Drean, Y., Lalou, Y., Barbier, M., Early home abortion and immediate contraception with Evra (R) patch, Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 40, 415-418, 2011</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text in French</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Patil, E., Edelman, A., Medical Abortion: Use of Mifepristone and Misoprostol in First and Second Trimesters of Pregnancy, Current Obstetrics and Gynecology Reports, 4, 69-78, 2015</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review article</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Platais, I., Tsereteli, T., Grebennikova, G., Lotarevich, T., Winikoff, B., Prospective study of home use of mifepristone and misoprostol for medical abortion up to 10 weeks of pregnancy in Kazakhstan, International Journal of Gynecology and Obstetrics, 134, 268-271, 2016</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 participants in the comparison group > 9 weeks’ gestation</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Provansal, M., Mimari, R., Gregoire, B., Agostini, A., Thirion, X., Gamerre, M., Medical abortion at home and at hospital: A trial of efficacy and acceptability, Gynecologie Obstetrique & Fertilite, 37, 850-856, 2009</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text in French</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Raghavan, S., Maistruk, G., Shochet, T., Bannikov, V., Posohova, S., Zhuk, S., Lishchuk, V., Winikoff, B., Efficacy and acceptability of early mifepristone-misoprostol medical abortion in Ukraine: Results of two clinical trials, European Journal of Contraception and Reproductive Health Care, 18, 112-119, 2013</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 63 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Schaff, E. A., Fielding, S. L., Westhoff, C., Ngai, S. W., For early medical abortion, 800 mug misoprostol was more efficacious as a single vaginal dose, than as two oral doses, Evidence-based Obstetrics and Gynecology, 4, 134-135, 2002</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 9 weeks were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Schellekens, M., Gomperts, R., Kleiverda, G., Danielsson, K. G., The outcome of home medical abortions provided through telemedicine, European Journal of Contraception and Reproductive Health Care, 21, 63-64, 2016</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Full text is an abstract. Further details about the study data is not available.</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Shannon, C. S., Winikoff, B., Hausknecht, R., Schaff, E., Blumenthal, P. D., Oyer, D., Sankey, H., Wolff, J., Goldberg, R., Multicenter trial of a simplified mifepristone medical abortion regimen, Obstetrics and Gynecology, 105, 345-351, 2005</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only cases with gestational age less than 49 days were included</td></tr><tr><td headers="hd_h_ch7.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tan, Y. L., Singh, K., Tan, K. H., Gosavi, A., Koh, D., Abbas, D., Winikoff, B., Acceptability and feasibility of outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation in Singapore, European Journal of Obstetrics Gynecology and Reproductive Biology, 229, 144-147, 2018</td><td headers="hd_h_ch7.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 participants (n=11) in the >9 weeks’ gestation comparison group</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch7appltab1"><div id="ch7.appl.tab1" class="table"><h3><span class="label">Table 4</span><span class="title">Research recommendation rationale</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appl.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appl.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Research question</th><th id="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">For women who are having medical abortion between 10<sup>+1</sup> and 12<sup>+0</sup> weeks, what is the efficacy and acceptability of expulsion at home compared to with expulsion in a clinical setting?</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance to ‘patients’ or the population</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>May expand access to medical abortion for woman</p>
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<p>Home expulsion may increase acceptability for women</p>
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<p>Home expulsion may be associated with less pain/ discomfort / anxiety for women</p>
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</td></tr><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to NICE guidance</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Determine the gestational limit for expulsion at home that offers the best balance of benefits and harms</td></tr><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to the NHS</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Expansion of access to medical abortion</p>
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<p>May liberate hospital / clinic resources for other procedures</p>
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</td></tr><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">National priorities</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Better use of hospital / clinic resources</td></tr><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non UK settings where abortion is restricted</td></tr><tr><td headers="hd_h_ch7.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</td><td headers="hd_h_ch7.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Home expulsion may facilitate access to medical abortion for women living far away from clinical settings/ hospitals</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">NHS: National Health Service; NICE: National Institute for Health and Care Excellence; UK: United Kingdom</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch7appltab2"><div id="ch7.appl.tab2" class="table"><h3><span class="label">Table 5</span><span class="title">Research recommendation modified PICO table</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561073/table/ch7.appl.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch7.appl.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criterion</th><th id="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women who are between 10<sup>+1</sup> and 12<sup>+0</sup> weeks pregnant seeking medical abortion</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Home expulsion</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital/ clinic expulsion</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Success of medical abortion, complications, pain, patient acceptability with setting, cost effectiveness</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timeframe</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td></tr><tr><td headers="hd_h_ch7.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Additional information</td><td headers="hd_h_ch7.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Permission from Department of Health needs to be sought to self-administer misoprostol at home for this study</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">RCT: randomized controlled trial</p></div></dd></dl></dl></div></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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