***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objectives To compare the efficacy of two different regimens of mifepristone followed by misoprostol for medical abortion in women with menstrual delay of ≤ 35 days BACKGROUND Medical abortion is under-used in developing countries . We assessed whether early fi rst-trimester medical abortion provided by midlevel providers ( government-trained , certified nurses and auxiliary nurse midwives ) was as safe and effective as that provided by doctors in Nepal . METHODS This multicentre r and omised controlled equivalence trial was done in fi ve rural district hospitals in Nepal . Women were eligible for medical abortion if their pregnancy was of less than 9 weeks ( 63 days ) and if they resided less than 90 min journey away from the study clinic . Women were ineligible if they had any contraindication to medical abortion . We used a computer-generated r and omisation scheme stratified by study centre with a block size of six . Women were r and omly assigned to a doctor or a midlevel provider for oral administration of 200 mg mifepristone followed by 800 μg misoprostol vaginally 2 days later , and followed up 10 - 4 days later . The primary endpoint was complete abortion without manual vacuum aspiration within 30 days of treatment . The study was not masked . Abortions were recorded as complete , incomplete , or failed ( continuing pregnancy ) . Analyses for primary and secondary endpoints were by intention to treat , supplemented by per- protocol analysis of the primary endpoint . This trial is registered with Clinical Trials.gov , NCT01186302 . FINDINGS Of 1295 women screened , 535 were r and omly assigned to a doctor and 542 to a midlevel provider . 514 and 518 , respectively , were included in the analyses of the primary endpoint . Abortions were judged complete in 504 ( 97.3 % ) women assigned to midlevel providers and in 494 ( 96.1 % ) assigned to physicians . The risk difference for complete abortion was 1.24 % ( 95 % CI -0.53 to 3.02 ) , which falls within the predefined equivalence range ( -5 % to 5 % ) . Five cases ( 1 % ) were recorded as failed abortion in the doctor cohort and none in the midlevel provider cohort ; the remaining cases were recorded as incomplete abortions . No serious complications were noted . INTERPRETATION The provision of medical abortion up to 9 weeks ’ gestation by midlevel providers and doctors was similar in safety and effectiveness . Where permitted by law , appropriately trained midlevel health-care providers can provide safe , low-technology medical abortion services for women independently from doctors . FUNDING UNDP/UNFPA/WHO/World Bank Special Programme of Research , Development and Research Training in Human Reproduction ( HRP ) , Department of Reproductive Health and Research ( RHR ) , World Health Organization OBJECTIVE To examine the feasibility , efficacy , safety , and acceptability of medical abortion  among rural and urban women up to 56 days of pregnancy in the Democratic People 's Republic of Korea . METHOD A total of 199 women ( rural n=95 , urban n=104 ) recruited from 2 rural and 2 urban reproductive health clinics received 200 mg of oral mifepristone followed 2 days later by 400 microg of sublingual misoprostol . The women 's abortion status and satisfaction level were determined 2 weeks later . RESULTS Overall complete abortion occurred in 96.0 % of the women ; there was no statistically significant difference between the groups ( rural 95.8 % , 95 % confidence interval [ CI ] , 89.6 - 98.8 ; urban 96.2 % , 95 % CI , 90.4 - 98.9 ) . The 2 groups reported similar adverse effects . In total , 90.5 % of rural and 88.5 % of urban participants were satisfied or very satisfied with the method . CONCLUSION The high efficacy and acceptability of medical abortion among rural and urban women suggest that medical abortion is a safe alternative to surgical abortion and can be scaled up to other reproductive health clinics in both rural and urban areas of the Democratic People 's Republic of Korea , provided that there is appropriate training and supervision BACKGROUND Home use of misoprostol for termination of pregnancy is still controversial in many countries . Acceptability of home use of misoprostol has been investigated in pregnancies below 49 days gestation . In this study , we aim ed to assess efficacy , feasibility and acceptability of home use of vaginal misoprostol for medical termination of pregnancy at 50 - 63 days compared with gestation of below 50 days among women who chose to administer misoprostol at home . METHODS In this prospect i ve study , mifepristone 200 mg was given in hospital under nursing supervision in the university hospital outpatient family planning clinic . Women self-administered misoprostol 800 microg vaginally 36 - 48 h later at home . Follow-up was 2 weeks later . Women with gestation of 50 - 63 days on the day of mifepristone administration were compared with women with gestation of below 50 days . Efficacy and feasibility were assessed by review of patient records and question naires . Acceptability was assessed using question naires where women reported on future choice of abortion method were they to have another abortion . RESULTS Among the 2992 women who had a medical abortion during the study period , 395 women chose to administer misoprostol at home and were included in the study . A total of 203 women were below 50 days gestation and 192 were between 50 and 63 days gestation . Efficacy was 97.5 % and did not differ between the groups . Surgical intervention was needed in 10 patients , of whom four were in the lower gestational b and ( P = 0.36 ) . No serious adverse events or blood transfusions were reported . Preference for home administration of misoprostol  , were they to have another induced abortion in the future , was high , 92.3 and 86.6 % respectively , and did not differ between the groups ( P = 0.097 ) . Need for extra analgesia significantly influenced women 's experiences in both gestational groups . CONCLUSIONS Medical abortion with mifepristone followed by home administration of vaginal misoprostol is safe and highly acceptable also to women with gestational length of 50 - 63 days as compared with shorter gestations . Efficacy , acceptability and preference for future place of administration of misoprostol  , were women to have another abortion , did not differ between women with gestation below 50 days or between 50 and 63 days BACKGROUND Unsafe abortion is a major cause of mortality among women in India accounting for 12 % of all maternal deaths . In developing countries , annually , up to 200,000 women die of complications after illegal abortion . Medical abortion is potentially a simple and a safe method for use in developing countries . We conducted a prospect i ve controlled trial to compare the efficacy of low-lose mifepristone and methotrexate for medical abortion . OBJECTIVE To find out the efficacy of low-dose mifepristone and methotrexate for inducing abortion . METHOD In this prospect i ve clinical study , 100 women opted for a medical method of abortion . Out of these , 50 patients were given 50 mg/m2 of methotrexate intramuscularly followed by 800 micro gm of intravaginal misoprostol , and 50 patients were given 200 mg of mifepristone orally followed by 800 micro gm of intravaginal misoprostol . MAIN OUTCOME MEASURES Complete abortion was the principal outcome measure . Secondary outcome measures were side effects and acceptability data . RESULTS The rate of expulsion by first week after initiation of treatment was 58 % in methotrexate and 98 % in mifepristone group ( P < 0.001 ) . CONCLUSION Low-dose mifepristone and intravaginal misoprostol is safe , effective , and well tolerated as compared to methotrexate and misoprostol Background Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion , which is achieved by increasing safe choices for pregnancy termination . Medical abortion for termination of early abortion is said to safe , effective , and acceptable to women in several countries . In Ethiopia , however , medical methods have , until recently , never been used . For this reason it is important to assess women 's preferences and the acceptability of medical abortion and manual vacuum aspiration ( MVA ) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services . Methods A prospect i ve study was conducted in two hospitals and two clinics from March 2009 to November 2009 . The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days ' estimated gestation . Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA . Question naires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit . Results The study groups were similar with respect to age , marital status , educational status , religion and ethnicity . Their mean age was about 23 , majority in both group completed secondary education and about half were married .  Place of residence and duration of pregnancy were associated with method choice . Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions ( 91.2 % vs 82.4 % ; P < .001 ) . Of those women who had medical abortion , ( 83.3 % ) would choose the method again if needed , and ( 77.4 % ) of those who had MVA would also choose the method again . Ninety four percent of women who had medical abortion and 86.8 % of those who had MVA would recommend the method to their friends . Conclusions Women receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion . We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination OBJECTIVE : To study the efficacy , safety , and acceptability of oral immediately swallowed and buccal misoprostol 800 mcg after mifepristone 200 mg for terminating pregnancy through 63 days since the last menstrual period ( LMP ) . METHODS : This seven-site study r and omly assigned 966 women seeking abortions to oral or buccal misoprostol 800 mcg 24–36 hours after mifepristone 200 mg with 7–14-day follow-up . RESULTS : Success rates in the oral and buccal groups were 91.3 % ( 389 of 426 ) and 96.2 % ( 405 of 421 ) , respectively ( P=.003 ; relative risk [ RR ] 0.95 , 95 % confidence interval [ CI ] 0.92–0.98 ) . Ongoing pregnancy occurred in 3.5 % ( 15 of 426 ) of women who took oral misoprostol compared with 1.0 % ( 4 of 421 ) of women in the buccal group ( P=.012 ; RR 3.71 , 95 % CI 1.24–11.07 ) . Through 49 days since the LMP , oral and buccal regimens performed similarly , but success with oral misoprostol  decreased as pregnancy advanced . In pregnancies of 57–63 days since the LMP , success with oral misoprostol  fell below 90 % , whereas that with buccal remained high ( oral 85.1 % [ 97 of 114 ] , buccal 94.8 % [ 109 of 115 ] , P=.015 , RR 0.90 , 95 % CI 0.82–0.98 ) . Furthermore , in this gestational age group , there were significantly more ongoing pregnancies among women who took misoprostol orally ( 7.9 % [ 9 of 114 ] ) compared with buccally ( 1.7 % [ 2 of 115 ] ; P=.029 , RR 4.54 , 95 % CI 1.0–20.55 ) . Adverse effect profiles were similar , although fever and chills were reported approximately 10 % more often among women who took buccal misoprostol .  Satisfaction and acceptability were high for both methods . CONCLUSION : Buccal misoprostol 800 mcg after mifepristone 200 mg is a good option for medical abortion through 63 days since the LMP . Oral misoprostol 800 mcg is also a safe and effective alternative , although success rates diminish with increasing gestational age . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00386867 LEVEL OF EVIDENCE : OBJECTIVE To assess the efficacy and acceptability of home administration of misoprostol for early medical abortion in Indian family planning clinics . METHODS In this prospect i ve cohort study , consenting pregnant women ( n=599 ) with amenorrhea of 8 weeks or less seeking termination of pregnancy received 200 mg of oral mifepristone followed 48 hours later with 400microg of oral misoprostol , administered either at home or at the clinic . RESULTS Almost all women ( 88.4 % ) chose to take  misoprostol home . There was no statistical difference in success rates between home and clin 
    Output:
    
Early medical abortion with mifepristone 200 mg followed by misoprostol is highly effective and safe