Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol

Peyron, Rémi; Aubeny, E.; Targosz, Veronique; Silvestre, Louise; Renault, Maguy; Elkik, F; Leclerc, Pascale; Ulmann, André; Ee, Baulieu

doi:10.1016/0020-7292(94)90087-6

Cited by 10 publications

(16 citation statements)

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“…11 Progesterone is essential for maintenance of pregnancy and helps in prolongation of pregnancy. [12][13][14][15][16][17] Delaying delivery may reduce the rate of long term morbidity by facilitating maturity of vital organs, help in optimum action of the administered glucocorticoids, helps in transfer to higher centre with NICU facilities. Though exact mechanism of action until very recently.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Patra¹,

Chattopadhyay²,

Munsi³

et al. 2015

jemds

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Preterm birth remains a major clinical problem. Prematurity is not only a major cause of perinatal mortality but also leads to greater risk for short and long term complications including disability and impediments in growth and mental development. To compare vaginal with intramuscular progesterone administration to prevent preterm labor and to detect the effect of both on the uterine and foetal circulations. STUDY DESIGN: comparative interventional study. POPULATION: 100 pregnant women attending NRSMCH Kolkata, Obstetrics emergency with threatened preterm labour before 34 weeks of gestation. STUDY PERIOD: one year. METHODS: Gestational age was confirmed clinically and by USG of early weeks of gestation. Efficacy and tolerability of progesterone in two routes i.e., intramuscular and vaginal for prevention of threatened preterm labour were compared. OUTCOME: Ante partum, intrapartum and perinatal outcomes were compared between two groups by statistical analysis of data's using chi-square test and student-t test. CONCLUSION: Vaginal progesterone was as effective as intramuscular progesterone in reducing preterm birth with fewer side effects in favor of vaginal route.

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Section: Introductionmentioning

confidence: 99%

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Patra¹,

Chattopadhyay²,

Munsi³

et al. 2015

jemds

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“…In pregnancy it works that it causes necrosis deciduae and detachment of the embryo affects the reduction of the inhibitory effect of progesterone on the uterine muscules and increases the sensitivity of the uterus to endogenous and exogenous prostaglandine (4,5). Also affects the structural changes in the cervix in terms softening and thus helps in the process of expulsion.…”

Section: Mifepristone and Misoprostolementioning

confidence: 99%

“…One of the first studies, that describe mifepristone (RU486) and misoprostole as aborifacient drugs, was published in France in 1993 (13). Administered dose is 600mg mifepristone, after 36 to 48 hours practiced 400μg misoprostolefor the purpose of termination of pregnancy of 49 days of gestation (7 weeks gestation).…”

Section: Mifepristone and Misoprostolementioning

confidence: 99%

Drug Methods for Arteficial Termination of Unwanted Pregnancy

Dimitrijević

2018

Serbian Journal of Experimental and Clinical Research

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“…The rate of complete abortion up to 63 days' gestation with mifepristone and misoprostol was reported to be 92-95% using the Food and Drug Administration-approved regimen. 1,2 In a recent study, the completion rates of 96-97% was reported in early pregnancy, including pregnancies up to 63 days' gestation. 3 Women choosing medical abortion must consent to undergo vacuum aspiration or dilatation and curettage in cases of incomplete abortion.…”

Section: Sirmentioning

confidence: 99%

Practice of self-medication of mifepristone-misoprostol drug combination for medical abortion

Godara

Kaushal

2014

Int J Basic Clin Pharmacol

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Practice of self-medication of mifepristone-misoprostol drug combination for medical abortionSir,Most medical abortion protocols require women to take mifepristone in the hospital setting. The rate of complete abortion up to 63 days' gestation with mifepristone and misoprostol was reported to be 92-95% using the Food and Drug Administration-approved regimen. 1,2 In a recent study, the completion rates of 96-97% was reported in early pregnancy, including pregnancies up to 63 days' gestation. 3Women choosing medical abortion must consent to undergo vacuum aspiration or dilatation and curettage in cases of incomplete abortion.Medical methods for first trimester abortion have been demonstrated to be both safe and effective. Regimens that combine mifepristone with a prostaglandin analogue such as misoprostol are more efficacious than a prostaglandin alone. Mifepristone, (RU 486, a substitute 19-norethisterone derivative)by blocking the progesterone receptors causes estrogen dominance and results in intrauterine fetal death. Simultaneously, it sensitizes the uterus to the activity of the prostaglandin. Thus, a combination of these two drugs is significantly more efficacious for termination of early pregnancy when compared to mifepristone given alone. A regimen that includes mifepristone in a dosage of 200 mg administered orally, followed by misoprostol in a dosage of 800 µg vaginally administered 48 hrs after mifepristone, and is highly effective for medical abortion up to 63 days gestation. This regimen is reported to be the best in most of the studies and moreover mifepristone serum levels do not increase proportionally with increasing oral doses. 4 In a study conducted by Schaff et al., it was observed that the success rate was seen in 96-97% of women who were prescribed a combination of mifepristone and misoprostol by authorized personnel at the hospital.3 Women are commonly advised to return for one or more follow-up visits, after 10-14 days because in cases of incomplete abortion she can be managed either expectantly, with an additional dose of misoprostol, or with an aspiration procedure. Women may be given the option of home administration of misoprostol after the initial clinic visit. 5However, the use of mifepristone -misoprostol combination for medical abortion used as self-medication, is rising due to changing socio-cultural practices and increased awareness among women for the termination of early pregnancy up to 63 days. It is observed that many women indulge in the practice of self-medication for termination of pregnancy. They take medicines either from local pharmacists, nurses, on advice of relatives, friends, husband, neighbors, newspaper articles, radio, television, magazines or any other such unauthorized sources for termination of pregnancy which mostly leads to incomplete abortion or many complications. It is observed that only few number of women have complete abortion with self-medication from an unauthorized source and moreover they suffer from pain and heavy bleeding when compared to normal m...

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Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol

Cited by 10 publications

References 0 publications

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Drug Methods for Arteficial Termination of Unwanted Pregnancy

Practice of self-medication of mifepristone-misoprostol drug combination for medical abortion

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