"Induction of Abortion with Mifepristone (RU 486) and Oral or Vaginal Misoprostol."

El-Refaey, Hazem; Rajasekar, Dhamnasekar; Abdalla, Mona; Calder, Lynda; Templeton, Allan

doi:10.2307/2138080

Cited by 37 publications

(54 citation statements)

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“…21 However, it has been reported that women preferred oral administration and valued having additional choice. 22 Sublingual administration avoids the first-pass effect through the liver associated with oral administration and the inconvenience and intrusion of vaginal administration.…”

Section: Discussionmentioning

confidence: 99%

Home self-administration of misoprostol for medical abortion up to 56 days' gestation

Hamoda

Ashok

Flett

et al. 2005

j fam plann reprod health care

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Objective Studies from the USA have suggested the feasibility and acceptability of home medical abortion, however the issue has not been addressed in the UK. This study aimed to assess the feasibility, efficacy and acceptability of home self-administration of misoprostol for medical abortion up to 56 days' gestation. Methods Mifepristone 200 mg was given orally in hospital under nursing supervision. Women were provided with misoprostol tablets 600 µg and advised to take them sublingually 36-48 hours later. The main outcome measures were (1) feasibility, assessed through successful completion of abortion at home without the need for hospital admission, (2) efficacy, assessed through complete uterine evacuation without the need for further medical or surgical intervention and (3) women's acceptability of the procedure as assessed by questionnaire. Results A total of 49 women participated in this study. Of these, 48 women aborted at home while one opted to be admitted to hospital after receiving misoprostol at home. One woman underwent surgical evacuation 5 weeks following abortion for excessive bleeding and retained products of conception. A total of 43/44 (98%) women were satisfied with having the abortion at home. Conclusions This study suggests the feasibility and acceptability of home self-administration of misoprostol for medical abortion up to 56 days' gestation. These findings need to be assessed in the context of a randomised trial. Key message pointsq This study suggests the feasibility and acceptability of home self-administration of misoprostol for medical abortion up to 56 days' gestation.q These findings and the potential cost implications for health service provision, need to be assessed in the context of a randomised trial.

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Section: Discussionmentioning

confidence: 99%

Home self-administration of misoprostol for medical abortion up to 56 days' gestation

Hamoda

Ashok

Flett

et al. 2005

j fam plann reprod health care

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“…Women in the expectant management arm were allowed home with no intervention. In the medical management arm, women with an incomplete miscarriage were admitted to hospital and given a single vaginal dose of 800 μg misoprostol 19 20. Women with early fetal or embryonic demise were pre-treated with a single oral dose of 200 mg mifepristone,21 then admitted to hospital 24-48 hours later for a single vaginal dose of 800 μg misoprostol.…”

Section: Methodsmentioning

confidence: 99%

Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial)

Trinder

Brocklehurst

Porter

et al. 2006

BMJ

266

255

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Objective To ascertain whether a clinically important difference exists in the incidence of gynaecological infection between surgical management and expectant or medical management of miscarriage. Design Randomised controlled trial comparing medical and expectant management with surgical management of first trimester miscarriage. Setting Early pregnancy assessment units of seven hospitals in the United Kingdom. Participants Women of less than 13 weeks' gestation, with a diagnosis of early fetal demise or incomplete miscarriage. Interventions Expectant management (no specific intervention); medical management (vaginal dose of misoprostol preceded, for women with early fetal demise, by oral mifepristone 24-48 hours earlier); surgical management (surgical evacuation). Main outcome measures Confirmed gynaecological infection at 14 days and eight weeks; need for unplanned admission or surgical intervention. Results 1200 women were recruited: 399 to expectant management, 398 to medical management, and 403 to surgical management. No differences were found in the incidence of confirmed infection within 14 days between the expectant group (3%) and the surgical group (3%) (risk difference 0.2%, 95% confidence interval − 2.2% to 2.7%) or between the medical group (2%) and the surgical group (0.7%, − 1.6% to 3.1%). Compared with the surgical group, the number of unplanned hospital admissions was significantly higher in both the expectant group (risk difference − 41%, − 47% to − 36%) and the medical group ( − 10%, − 15% to − 6%). Similarly, when compared with the surgical group, the number of women who had an unplanned surgical curettage was significantly higher in the expectant group (risk difference − 39%, − 44% to − 34%) and the medical group ( − 30%, − 35% to − 25%). Conclusions The incidence of gynaecological infection after surgical, expectant, and medical management of first trimester miscarriage is low (2-3%), and no evidence exists of a difference by the method of management. However, significantly more unplanned admissions and unplanned surgical curettage occurred after expectant management and medical management than after surgical management. Trial registration National Research Register: N0467011677/N0467073587.

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“…92-98% (8,9,17,18) and 600 mg i.e. 87-97% (19,20), demonstrating the potential efficacy of 100 mg mifepristone for medical abortion. Efficacy of low dose mifepristone was also reported by Jerbi et al (13).…”

Section: Discussionmentioning

confidence: 98%

Is mifepristone 100mg an effective alternative to standard dose for medical abortion

Goel¹,

Mittal²,

Taneja³

et al. 2010

J Turkish German Gynecol Assoc

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"Induction of Abortion with Mifepristone (RU 486) and Oral or Vaginal Misoprostol."

Cited by 37 publications

References 0 publications

Home self-administration of misoprostol for medical abortion up to 56 days' gestation

Home self-administration of misoprostol for medical abortion up to 56 days' gestation

Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial)

Is mifepristone 100mg an effective alternative to standard dose for medical abortion

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