Safety of Supervised and Unsupervised Consumption of Oral Drugs for Inducing Abortion and Associated Adverse Outcomes: A Systematic Review and Meta-Analysis.

Diksha Gautam, International Institute of Health Management and Research (IIHMR)
Anuj Kumar Pandey, International Institute Of Health Management Research - IIHMR
sutapa bandyopadhyay, International Institute of Health Management Research, New Delhi
Benson Thomas M, SRM Institute of Science and Technology, Chennai

The safety of consumption of abortifacients, whether unsupervised or supervised is a concern, especially when consumed in the first trimester which is the most critical time of pregnancy. This review aims to elucidate the prevalence of unsupervised/supervised consumption of oral abortifacients, documented comparative risks and adverse effects of unwarranted medicinal preparations used to induce abortion. Study was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2015 guideline. 15 studies (n=8,089) yielded a pooled prevalence of consuming unsupervised oral abortifacients. To assess the pooled prevalence of maternal adverse outcomes, 79 studies, 10 unsupervised (n=1,472) and 69 supervised (n=48,704) were studied. Prevalence of consuming unsupervised abortifacients was 35% [95% CI: 23; 50]. Prevalence of adverse outcomes from unsupervised abortifacients was almost double [19% (95% CI: 14; 26)] as that of supervised abortifacients [9% (95%CI: 10;16)]. Adverse outcomes were high in the LMICs (13%), when consumed in second trimester (15%), and women who consumed only oral abortifacient drugs (29%). Failure of abortion and abnormal heavy bleeding were the majorly reported outcomes with high prevalence. Easy availability of common abortifacient drugs like over-the-counter sale may engender distinct arrays of maternal complications.

Keywords: Sexual and Reproductive Health and Rights, Health and Morbidity, Population Policies, Family Planning and Contraception

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