Annexes

Annex 7. Systematic reviews and links to PICOs and recommendations

I. Topics scoped for development of new or updated recommendations

Topic area Title and authors of review (and reference details, if published) Related PICO numbers(s), as listed in annexes Related recommendation number(s) as presented in the main document
Law and policy topics For the Evidence-to-Decision (EtD) frameworks, refer to Supplementary material 1 All reviews conducted by the Law and Policy Evidence Synthesis Team for development of this guideline[1] Refer to Annex 8  
Criminalization[2] Impact of criminalization on abortion-related outcomes 1 1
Grounds-based approaches Impact of grounds on abortion-related outcomes 2 2
Gestational age limits Impact of gestational limits on abortion-related outcomes 3 3
Mandatory waiting periods Impact of mandatory waiting periods on abortion-related outcomes 4 6
Third-party authorization Impact of third-party authorization on abortion-related outcomes 5,6,7,8,9 7
Abortion provider restrictions Impact of provider restrictions on abortion-related outcomes 10 21
Conscientious objection Impact of conscientious objection on abortion-related outcomes 11 22
Clinical service topics For the Evidence-to-Decision (EtD) frameworks, refer to Supplementary material 2 All reviews conducted by the Clinical services Evidence Synthesis Team for development of this guideline Refer to Annex 9  
Rh isoimmunization New systematic review: Chan M, Gill R, Kim C. The effect of routine anti-D administration among unsensitized Rh negative individuals who have an abortion. BMJ Sex Reprod Health. 2021 (in press). 1 8
Pain management for surgical abortion Updated review by Cochrane Fertility Regulation (CFR) Group: Renner R-M, Edelman A, McKercher AE, Jensen JTJ, Nichols MDN. Pain control in first trimester surgical abortion. 2020 (forthcoming) New systematic review: DePiñeres T. Pain management regimens for surgical abortion > 14 weeks gestation. 2020 (unpublished) 2, 3 11 & 12          
13 & 14
Pain management for medical abortion New review by CFR Group: Reynolds-Wright JJ, Woldetsadik MA, Morroni C, Cameron S. Pain management for medical abortion before 14 weeks’ gestation. 2020 (forthcoming) New systematic review: Korotkaya Y, Kim C. Pain control in second-trimester medical termination of pregnancy: a systematic review. 2019 (unpublished) 4, 5 15        
16
Cervical priming prior to surgical abortion < 12 weeks Updated review by CFR Group: Kapp N, Nguyen A, Atrio J, Lohr P. Cervical preparation for surgical abortion less than 14 weeks. 2020 (forthcoming) 6a 17
Cervical priming prior to surgical abortion ≥ 12 weeks Updated review by CFR Group: Newmann SJ, Tufa T, Drey E, Meckstroth K, Diedrich JT. Cervical preparation for second trimester dilation and evacuation. 2019 (forthcoming) 6b,7,8,9 18
Other medical methods to induce abortion New systematic review: Tolu L, Kim C. The efficacy, safety, and acceptability of alternative methods of medication abortion to the routine mifepristone and/or misoprostol. 2020 (manuscript in progress) 10,11,12 27c
Missed abortion < 14 weeks New systematic review: DePiñeres T. Management options for pregnant individuals with missed abortion < 14 weeks. 2020 (unpublished) 13,14,15 31
Self-management of medical abortion (eligibility, administration of medications, assessment of outcome) New systematic review: Clark E, Tolu L, Gill R, Kim C. Eligibility and outcome assessment. 2020 (unpublished)
New review by CFR Group: Gambir K, Kim C, Necastro KA, Ganatra B, Ngo TD. Self-administered versus provider-administered medical abortion. Cochrane Database Syst Rev. 2020;(3):CD013181.
16 50 (Self-management)
Service delivery topics For the Evidence-to-Decision (EtD) frameworks, refer to Supplementary material 3 All reviews conducted by the Service delivery Evidence Synthesis Team for development of this guideline Refer to Annex 10  
Provision of information Updated review by Cochrane Response (on pharmacy workers): Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: information provision by pharmacy workers. 2021 (unpublished) 1 4
Counselling Updated review by Cochrane Response (on traditional and complementary medicine professionals, pharmacists, pharmacy workers and community health workers): Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: pre- and post-abortion counselling. 2021 (unpublished) 2 5
Cervical priming using osmotic dilators or medication prior to induced surgical abortion Updated review by Cochrane Response (on traditional and complementary medicine professionals, associate/advanced associate clinicians, midwives, nurses or auxiliary nurses/auxiliary nurse midwives): Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Cervical priming using osmotic dilators or medications. 2021 (unpublished) 3 19 & 20
Vacuum aspiration for all indications at < 14 weeks Vacuum aspiration for management of incomplete abortion Updated Cochrane review (on traditional and complementary medicine professionals, auxiliary nurse midwives, auxiliary nurses, nurses, midwives, associate/advanced associate clinicians): Kim C, Barnard S, Park MH, Ngo TD. Doctors or mid‐level providers for abortion. Cochrane Database Syst Rev. 2021 (forthcoming) 4 & 10 24 & 38
Dilatation and evacuation (D&E) for surgical abortion at ≥ 14 weeks New systematic review (on traditional and complementary medicine professionals, associate/advanced associate clinicians, midwives): Feyssa M, Kim C. Systematic review on effectiveness, safety and acceptability of second trimester abortion by midlevel providers. 2021 (unpublished) 5 26
Medical abortion at < 12 weeks (eligibility, administration of medications, assessment of outcome) Updated Cochrane review (on traditional and complementary medicine professionals, auxiliary nurse midwives, auxiliary nurses, midwives, nurses, associate/advanced associate clinicians): Kim C, Barnard S, Park MH, Ngo TD. Doctors or mid‐level providers for abortion. Cochrane Database Syst Rev. 2021 (forthcoming)
New review by Cochrane Response (on pharmacists, pharmacy workers and community health workers): Villanueva G, Cogo E, Petkovic J, Bergman H, Probyn K, Buckley B, et al. Medical abortion facilitation. 2021 (unpublished)
6 28
Medical abortion at ≥ 12 weeks New systematic review (on traditional and complementary medicine professionals, associate/advanced associate clinicians, midwives, nurses, auxiliary nurses): Feyssa M, Kim C. Systematic review on effectiveness, safety and acceptability of second trimester abortion by midlevel providers. 2021 (unpublished) 7 30
Medical management of intrauterine fetal demise (IUFD) New review by Cochrane Response: Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: medical management of intrauterine fetal demise (IUFD). 2020 (unpublished) 8 33
Medical management of incomplete abortion Updated review by Cochrane Response: Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: medical management of incomplete abortion. 2020 (unpublished) 9 37
Diagnosis and management of abortion-related complications Updated review by Cochrane Response (on traditional and complementary medicine professionals, associate/advanced associate clinicians, midwives, nurses, auxiliary nurses/auxiliary nurse midwives):
Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: diagnosis and management of abortion related complications. 2021 (unpublished)
11 39 & 40
Delivery of injectable contraceptives Updated review by Cochrane Response (on traditional and complementary medicine professionals medicine, pharmacists, pharmacy workers)
Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: injectable contraception. 2020 (unpublished)
12 46
Telemedicine for provision of medical abortion care (comprehensive abortion care or individual components) Updated review by Cochrane Response:
Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: telemedicine. 2020 (unpublished)
13 48
Community-based outreach models for provision of abortion care New systematic review by Cochrane Response:
Villanueva G, Probyn K, Bergman H, Petkovic J, Cogo E, Buckley B, et al. Health worker roles in providing safe abortion care and post-abortion contraception: Community outreach models. 2021 (unpublished)
14 49 (Best practice statement [BPS])
Harm-reduction counselling for persons seeking induced abortion New systematic review:
Stifani B, Gill R, Kim C. Harm-reduction counselling to reduce the harms of unsafe abortion: a systematic review. 2021 (manuscript under review)
15 49 (BPS)
Social marketing outreach for pregnant women seeking induced abortion New systematic review:
Abubeker F, Tufa T, Kim C. Impact of social marketing interventions on safe abortion services. 2021 (unpublished)
16 49 (BPS)
Self-sourcing of medications through online services for pregnant women seeking induced abortion New systematic review:
Abubeker F, Tufa T, Kim C. Safety, effectiveness, and acceptability of self-sourcing of medications for induced abortion. 2021 (unpublished)
17 49 (BPS)
Self-administration of injectable contraceptives in the post-abortion period Updated review by Cochrane Response:
Villanueva G, Bergman H, Cogo E, Petkovic J, Buckley B, Probyn K, et al. Health worker roles in providing safe abortion care and post-abortion contraception: self-administration of injectable contraceptives. 2020 (unpublished)
18 51 (Self-management)

II. Topics not scoped, but an updated evidence review was conducted

Topic area Title and authors of review (and reference details, if published) Related PICO numbers(s), as listed in annexes Related recommendation number(s) as presented in the main document
Prophylactic antibiotics Existing review: Low N, Mueller M, Van Vliet HAAM, Kapp N. Perioperative antibiotics to prevent infection after first-trimester abortion. Cochrane Database Syst Rev. 2012;(3):CD005217. (Updated evidence review conducted in 2021) N/A 9
Pre-abortion ultrasound Existing review: Kulier R, Kapp N. Comprehensive analysis of the use of pre-procedure ultrasound for first-and second-trimester abortion. Contraception, 2011;83(1):30-3. (Updated evidence review conducted by Cochrane Response in April 2021) N/A 10
Surgical methods for first trimester abortion Existing review: Kulier R, Cheng L, Fekih A, Hofmeyr GJ, Campana A. Surgical methods for first trimester termination of pregnancy. Cochrane Database Syst Rev. 2001;(4):CD002900. (Updated evidence review conducted in April 2021) N/A 23
Medical management of induced abortion   Existing review: Abubeker FA, Lavelanet A, Rodriguez MI, Kim C. Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: a systematic review. BMC Womens Health. 2020;20(1):142.
Updated review: Whitehouse K, Brant A, Sporstol Fonhus M, Lavelanet A, Ganatra B, et al. Medical regimens for abortion at 12 weeks and above: a systematic review and meta-analysis. Contracept X. 2020;2:100037.
N/A 27            
29
Medical management of IUFD Existing review: Cleeve A, Fønhus MS, Lavelanet A. A systematic review of the effectiveness, safety, and acceptability of medical management of intrauterine fetal death at 14—28 weeks of gestation. Int J Gynaecol Obstet. 2019;147(3):301-12. N/A 32
Post-abortion follow-up Existing reviews: Grossman D, Ellertson C, Grimes DA, Walker D. Routine follow-up visits after first-trimester induced abortion. Obstet Gynecol. 2004:103(4):738-45.   Grossman D, Grindlay K. Alternatives to ultrasound for follow-up after medication abortion: a systematic review. Contraception. 2011:83(6):504-10. (Updated evidence review conducted by Cochrane Response in April 2021) N/A 34

III. Topics for recommendations that were carried forward or brought into this guideline without further review

Topic area Title and authors of review (and reference details, if published) Related PICO numbers(s), as listed in annexes Related recommendation number(s) as presented in the main document
Methods of surgical abortion at gestational ages ≥ 14 weeks Carried forward: Lohr PA, Hayes JL, Gemzell-Danielsson K. Surgical versus medical methods for second trimester induced abortion. Cochrane Database Syst Rev. 2008;(1):CD006714. N/A 25 (Recommendation 5 from WHO, 2012)
Medical management of incomplete abortion Carried forward: Kim C, Barnard S, Neilson JP, Hickey M, Vazquez JC, Dou L. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017(1);CD007223. N/A 35 36a & 36b (Recommendations 1a and 1b from WHO, 2018)
Post-abortion contraception Brought in: Refer to Medical eligibility criteria for contraceptive use (WHO, 2015) N/A 41 (Recommendation from the MEC, WHO, 2015)
Timing of contraception and surgical abortion Carried forward: N/A N/A 42 (Recommendation 13 from WHO, 2012)
Timing of contraception and medical abortion Carried forward: Kim C, Nguyen AT, Berry-Bibee E, Ermias Y, Gaffield ME, Kapp N. Systemic hormonal contraception initiation after abortion: a systematic review and meta-analysis. Contraception. 2021;103(5):291-304. Ermias Y, Berry-Bibee E, Nguyen AT, Curtis K. Post-abortion IUD insertion: a systematic review. 2017 (unpublished) N/A 43 (Recommendations 4a and 4b from WHO, 2018)  
44 (Recommendation from WHO, 2015)
Insertion and removal of implants Tubal ligation Carried forward: Refer to OptimizeMNH guideline (WHO, 2012) N/A 45 47 (Recommendations from WHO, 2015)
Over-the-counter oral contraceptive pills Over-the-counter emergency contraceptive pills Condom use Brought in: Refer to Self-care interventions for health and well-being (WHO, 2021) N/A 52 (Self-management) 53 (Self-management) 54 (Self-management)

Footnotes

  1. Authors of all seven reviews include: Amanda Cleeve, Fiona de Londras, Alana Farrell, Magdalena Furgalska, Antonella Lavelanet, Maria Isabel Rodriguez.
  2. These first three recommendations are presented in Chapter 2. The remainder are presented in Chapter 3.