This study aimed to investigate the effectiveness and safety of lower doses of mifepristone combined with misoprostol for the termination of ultra-early pregnancy. A total of 2500 women with ultra-early pregnancy (amenorrhea ≤ 35 days) were randomly divided into 5 groups with gradually decreased dose of oral mifepristone from 150 to 50 mg followed by 200 µg of oral misoprostol 24 hours later. The primary end point was complete abortion without surgical intervention. Secondary end points were vaginal bleeding, return of menses, and side effects. Rates of complete abortion were high in all groups. Moreover, the lower doses of mifepristone led to shorter vaginal bleeding period, the return of menses on the expected date, and fewer side effects. Lower doses of mifepristone combined with 200 µg of misoprostol are as effective and safe as higher doses of this combination for the termination of ultra-early pregnancy with lower possibility of vaginal bleeding and side effects.

The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration. The primary end point was complete abortion. Secondary end points were rates of unscheduled reattendance, time required for and cost of hospital observation and follow-up, vaginal bleeding, adverse effects, menstrual disturbance in the posttreatment period, and satisfaction rating. No differences in the rates of complete abortion, unscheduled reattendance, vaginal bleeding, adverse effects, or return of posttreatment menstruation were observed. The time required for (and costs of) hospital observation and follow-up per participant was 557.82 minutes (and US$40.12) in the hospital administration group and 18.46 minutes (and US$1.96) in the self-administration group (both P < .001). Satisfaction rates were similar in both groups, but the rates of "very satisfied" responses (87.60% vs 25.41%) and follow-up compliance (loss to follow-up, 0.45% vs 7.70%) were higher in the self-administration group (both P < .001). Low-dose mifepristone combined with self-administered misoprostol for ultra-early pregnancy termination was as effective and safe as hospital administration, with greater acceptability and lower cost to the women.

AimThe aim of the present study was to investigate the safety and efficacy of low‐dose mifepristone combined with self‐administered misoprostol for termination of early pregnancy.MethodsA total of 533 women seeking medical abortion in early pregnancy (≤49 days since the last menstrual period) were divided randomly into hospital‐ (H‐Mis, 250) and self‐ (S‐Mis, 283) administered misoprostol groups. Women in two groups took 100 mg of oral mifepristone in hospital followed by 200 μg of sublingual misoprostol 24 h later in hospital or home. The primary outcome parameter was complete abortion without surgical intervention. Secondary outcomes were uterine bleeding, return of regular menses, side effects and patient acceptability.ResultsHigh rates of complete abortion were observed for both the H‐Mis group (243/250; 94.8%) and the S‐Mis group (266/283; 94.0%). No significant differences in outcomes (complete abortion/failure rates) or side effects were observed between the two groups. General satisfaction rates were similar for the two groups (H‐Mis, 231/250, 92.4%; S‐Mis, 263/283, 92.9%; P > 0.05). Higher convenience of administration (H‐Mis, 211/250, 84.4%; S‐Mis, 270/283, 95.4%; P < 0.05) and privacy protection (H‐Mis, 214/250, 85.6%; S‐Mis, 267/283, 94.3%; P < 0.05) satisfaction rates were obtained for the S‐Mis group than for the H‐Mis group.ConclusionSelf‐administered sublingual misoprostol is as safe and effective as hospital‐administered misoprostol following low‐dose mifepristone to terminate early pregnancy (≤49 days of amenorrhoea) with fewer side effects.

Menstrual regulation with low-dose mifepristone and misoprostol at expected menstruation can be efficacious and highly acceptable to maintain or restore non-pregnant status, which may have potential for routine contraception.

To clarify the effect of retinoid X receptor-a/g (RXR-α/γ) genes functional genetic variants (RXR-α rs4842194 G&gt;A, RXR-γ rs100537 A&gt;G and rs2134095 T&gt;C) on the risk of gestational diabetes mellitus (GDM), a case-control study with 573 GDM patients and 740 pregnant women with normal glucose tolerance was performed in Guangxi area of China. An odds ratio (OR) with its corresponding 95%CI was used to assess the strengths of the association between genetic variation and GDM. After adjustment of age and pre-BMI, the logistic regression analysis showed that the rs2134095 was significantly associated with GDM risk (CC vs. TT/TC: adjusted OR=0.71, 95%CI=0.56~0.90) in all subjects, and this result remained highly significant after Bonferroni’s correction for multiple testing (P=0.004). The stratified analysis showed that rs2134095 was significantly associated with the risk of GDM among age&gt;30 years (adjusted OR=0.61, 95%CI=0.39~0.97), BMI&gt;22 kg/m2 (adjusted OR=0.46, 95%CI= 0.30~0.70), SBP&gt;120mmHg (adjusted OR=1.96, 95%CI= 1.14~3.36), HbA1c&lt;6.5%(adjusted OR=1.41, 95%CI=1.11~1.78), TG≤1.7mmol/L(adjusted OR=2.57,95%CI=1.45~4.53), TC≤ 5.18mmol/L (adjusted OR=1.58, 95%CI=1.13~2.22), HDL-c≤1.5mmol/L(adjusted OR=1.70, 95%CI= 1.16~2.49) and LDL-c&gt; 3.12 mmol/L(adjusted OR= 1.47, 95%CI= 1.08~2.00) subjects, under the recessive genetic model. We also found that rs2134095 interacted with age (Pinteraction=0.039), pre-BMI (Pinteraction=0.040) and TG (Pinteraction=0.025) influencing individual's genetic susceptibility to GDM. The rs2134095 T&gt;C is significantly associated with the risk of GDM by effect of a single locus and / or complex joint gene-gene and gene-environment interactions. Larger sample-size and different population studies are required to confirm the findings.