Early Termination of Pregnancy with Mifepristone (RU486) and the Orally Active Prostaglandin Misoprostol.

Peyron, Rémi; Aubeny, E.; Targosz, Veronique; Silvestre, Louise; Renault, Maguy; Elkik, F; Leclerc, Philippe; Ulmann, André; Baulieu, Étienne-Émile

doi:10.2307/2939250

Cited by 17 publications

(23 citation statements)

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“…(1) Peyron et al in 1993 in a study with mifepristone with misoprostol combination reported 96.9% complete abortion with 0.8% incomplete abortion, which is on par with our study. (2) Vomiting was seen in 8% of our patients unlike the study of Cabeza et al in 1998 where it was 15%. (8) Spitz reports 100% bleeding in his study in contrast to only 28% of our patients had excessive bleeding.…”

Section: Discussioncontrasting

confidence: 53%

“…Hence, safe and simple abortion procedures and techniques for early-induced abortion are the need of the hour. (2) The methods available for first trimester abortion are menstrual regulation, manual/electrical vacuum aspiration, dilation and curettage, laminaria tent, and prostaglandins for cervical dilation, and medical methods. (3) Although, various methods are available, each has its own complications like, excessive bleeding, uterine perforation, syncopal attacks, shock, infection, incompetence of os, cervical stenosis, Asherman syndrome, chronic pelvic inflammatory disease, and infertility.…”

mentioning

confidence: 99%

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Comparative Study of the Efficacy of Mifepristone With Vaginal Misoprostol and Vaginal Misoprostol Alone for First Trimester Abortion

Raj¹,

Rajaragupathy²

2016

jemds

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OBJECTIVESTo assess the efficacy of mifepristone with misoprostol combination in first trimester abortion. To compare this combination with vaginal misoprostol alone for the first trimester MTP. To compare the various parameters involved in MTP in both the methods and assess the most suitable method for first trimester MTP. METHODSAn interventional prospective study conducted in the Department of Obstetrics and Gynaecology at Government Thoothukudi Medical College, Thoothukudi, during 2013Thoothukudi, during -2015. During this study, 125 patients who attended the family planning clinic requesting first trimester termination of pregnancy were selected based on the inclusion, exclusion criteria. Out of 125 patients, 100 were randomly assigned to vaginal misoprostol group and 25 to mifepristone with misoprostol group. The study was approved by the hospital ethical committee. RESULTSOn analysing both the methods had less induction abortion interval, but 93% of abortions occurred within 4 hours of administration in mifepristone and vaginal misoprostol. CONCLUSIONThus, the combined regimen has more rate of complete abortion with less induction abortion interval than when misoprostol alone was used.

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Section: Discussioncontrasting

confidence: 53%

mentioning

confidence: 99%

Comparative Study of the Efficacy of Mifepristone With Vaginal Misoprostol and Vaginal Misoprostol Alone for First Trimester Abortion

Raj¹,

Rajaragupathy²

2016

jemds

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“…Gemeprost is the only prostaglandin licensed in the UK for induction of abortion. However, misoprostol, an orally active prostaglandin analogue marketed for the treatment and prevention of peptic ulcer, has uterotonic properties 8 and has been shown to be effective at inducing abortion in first and second trimester pregnancies 9,10 . Although the tablets of mifepristone are formulated for oral use, vaginal administration is more effective and may be associated with a lower incidence of side effects at least in the first trimester 10 .…”

Section: Introductionmentioning

confidence: 99%

A randomised study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy

Bartley

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To compare the effectiveness of gemeprost and misoprostol as prostaglandins used in combination with mifepristone for induction of mid-trimester termination. Design Randomised trial.Setting Scottish teaching hospital.Sample One hundred women undergoing abortion between 12 and 20 weeks.Methods Each woman received 200 mg mifepristone and 36-48 hours later either 1 mg gemeprost vaginal pessary every 6 hours for 18 hours or 4 Â 200 Ag misoprostol tablets vaginally followed by 2 Â 200 Ag misoprostol tablets orally every 3 hours for 12 hours. Success was defined as the percentage of women aborted within 24 hours of the first administration of prostaglandin. Main outcome measures Prostaglandin -abortion interval and side effects.Results There were no significant differences in median prostaglandin -abortion interval between gemeprost (6.6 hours 95% CI 6.0-10.7) and misoprostol (6.1 hours 95% CI 5.5-7.5) ( P ¼ 0.22). The cumulative abortion rates at 24 hours (96% vs 94%, respectively), the surgical evacuation rates (12% and 10%) and the incidence of vomiting, diarrhoea and pain were similar. Conclusion Two hundred milligrammes of mifepristone followed 36 -48 hours later by either vaginal gemeprost or misoprostol is a highly effective way of inducing abortion in the second trimester of pregnancy.

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“…15 Vaginal administration of misoprostol was associated with a lower frequency of adverse effects as shown by Hertzen et al None of the women in either group had serious problems enough to have medical consultation. In contrast to 29% women of USA study received narcotic analgesia, women of our study needed only NSAID.…”

Section: Discussionmentioning

confidence: 81%

A Randomized Trial of Hospital Vs Home Self Administration of Vaginal Misoprostol for Medical Abortion

Shrestha¹,

Sedhai²

2015

Kathmandu Univ. Med. J.

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BackgroundA combination of mifepristone followed after 24 hrs by misoprostol has proved a safe and effective abortifacient for termination of early pregnancy. Home use of misoprostol for medical abortion is still controversial in many countries including ours where women's literacy rate is low. Particularly in developing countries, this method markedly decreased the hospital visit which would be beneficial to patients and hospital staff. ObjectiveTo see whether the home self administration of vaginal misoprostol was equally effective as administered by trained staff in terms of successful termination of early pregnancy. Secondary outcomes were bleeding and pain duration during medical abortion, side effects, reason for termination of pregnancy and women's acceptability of the procedure. MethodOne hundred and eighty eight women requesting medical abortion with pregnancy less than 63 days gestation were randomized into two groups either self administration of vaginal misoprostol (800 mcg) at home or hospital administration 24 hours after oral 200 mg mifepristone. Ultrasound was performed after 14 days to confirm complete abortion. ResultThe overall success rate was similar in two groups: 89.13% on home group Vs 86.9% in hospital group. Eleven out of 18 women (61.1%) having incomplete abortion had successful termination after 2 nd dose misoprostol( 400 mcg). None of the women had continued pregnancy. Multigravida had slightly higher risk of failure (R.R: 1.04). ConclusionHome self administration of vaginal misoprostol was safe and effective for early termination of medical abortion and was acceptable. Use of extra dose of misoprostol has advantage of higher completion rate of abortion.

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Early Termination of Pregnancy with Mifepristone (RU486) and the Orally Active Prostaglandin Misoprostol.

Cited by 17 publications

References 0 publications

Comparative Study of the Efficacy of Mifepristone With Vaginal Misoprostol and Vaginal Misoprostol Alone for First Trimester Abortion

Comparative Study of the Efficacy of Mifepristone With Vaginal Misoprostol and Vaginal Misoprostol Alone for First Trimester Abortion

A randomised study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy

A Randomized Trial of Hospital Vs Home Self Administration of Vaginal Misoprostol for Medical Abortion

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