Medical methods for first trimester abortion

Kulier, Regina; Kapp, Nathalie; Gülmezoglu, A Metin; Hofmeyr, G Justus; Liu, Cheng; Campana, A.

doi:10.1002/14651858.cd002855.pub4

Cited by 148 publications

(71 citation statements)

References 88 publications

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“…Medical methods of abortion have been proved to be safe and effective [2]. The most effective regimens rely on the antiprogestin, mifepristone, which binds to progesterone receptors resulting in necrosis and detachment of placenta.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy

Akkenapally

2016

J Obstet Gynecol India

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Objective To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14-20 weeks). Materials and methods The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women.Group-I received only misoprostol; 600 mcg initial vaginal insertion followed by 400 mcg sublingually every 3 h until termination. Women in Group-II received mifepristone 200 mg and after 24 h started with 600 mcg misoprostol, per vaginal followed by 400 mcg sublingually till abortion was completed, up to a maximum of five doses in both groups. Results The success rate in Group-I was 89 %, whereas in Group-II it was 96 %. The mean induction abortion interval in Group-I was 10.67 ± 3.96 h compared to Group-II which was significantly less 6.19 ± 2.70 h (p value \ 0.01). The mean dose of misoprostol in Group-I was 1610 ± 511.18 mcg and in Group-II, it was lesser 1046 ± 392.71 mcg (p value \ 0.01). There was significant difference in the mean blood loss also, 97.20 ± 36.35 ml in Group-I and 52.55 ± 27.96 ml in Group-II. Also among the individual groups multigravidae and lower gestational age (\17 weeks), women had lesser IAI as well as lesser misoprostol dose was required. 123Conclusion Pretreatment with mifepristone significantly reduces the induction abortion interval and the misoprostol dose along with minimal blood loss.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy

Akkenapally

2016

J Obstet Gynecol India

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“…The advantages of a first trimester medical abortion are non-invasive procedure; no surgical instrumental usage; no anesthesia performed; oral or injected drug usage and procedure resembling a natural abortion. The disadvantages of medical abortion are decreased effectiveness after the seventh week; required multiple visits to the doctor by the procedure; lasts longer bleeding after the abortion and presenting the contents of her womb as it is expelled [2].…”

Section: Discussionmentioning

confidence: 99%

“…Serious complications resulting from abortions performed during this period are rare [6]. Dosage of cytotec usage was varied from 100 to 600 micrograms every 4 to 12 hours [7]. The common dosage of cytotec usage was 400 micrograms every 6 hours.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic abortion in Siriraj Hospital: A 10-year review

Chawanpaiboon¹,

Neungton²

2013

OJOG

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Objective: To assess indications, methods of interventions and gestational age of women underwent therapeutic abortion. Method: A total of 1381 cases of pregnant women underwent therapeutic abortion with completed charts between 1 st January, 2001 to 31 st December, 2010, were enrolled in this study. The patient data including demographic data, gestational age of abortion, methods of abortion, dosage of cytotec usage, indications of abortion and length of hospital stay were recorded. RESULT: Mean maternal age, gestational age of abortion and abortus weight were 29.56 ± 7.09 years, 17.54 ± 6.05 weeks of gestation and 401.27 ± 269.49 grams, respectively. Induced abortion with cytotec and syntocinon was mostly (28.3%) and rarely used (1.3%), respectively. Dosage of cytotec usage of 400 micrograms every 6 hours regimen was mostly used (53.1%). Indications of therapeutic abortion were maternal HIV infection (18.5%), fetal structural abnormalities (17.7%) and dead fetus in utero (19.3%) and were found. Curettage alone was mostly performed in the indicated patients with gestational age of 9.07 ± 2.85 weeks. Medical cytotec and syntocinon alone were mostly performed in the indicated patients with gestational age of 19.51 ± 4.55 and 23.94 ± 4.67 weeks, respectively. Tubal sterilization and the length of hospital stay were higher in the group of therapeutic abortion with maternal indication. Therapeutic abortion by hysterotomy had higher length of hospital stay than those with curettage method. Conclusion: Indications of therapeutic abortion were mostly from maternal HIV infection, fetal structural abnormalities and dead fetus in utero. Medical and surgical interventions were mostly applied during mid and early gestation, respectively.

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“…As a result of that, unsafe abortions are made approximately 19 -20 million per year [2]. Various drugs have been used for the legal medical first trimester termination, but the most common combination is mifepris-tone-misoprostol [3]. As an antiprogesterone, mifepristone blocks the receptors for progesterones and glucocorticoids and increases the sensitivity of the uterus to prostaglandins.…”

Section: Introductionmentioning

confidence: 99%

“…This blockage results in the breakdown of maternal capillaries in the deciduas, the synthesis of prostaglandins by the epithelium of decidual glands and inhibition of prostaglandin dehydrogenase. The successful medical treatment of legal abortion up to 63 days of gestation is demonstrated in various studies [3]- [7]. According to Cochrane reviews [3], medical treatment achieves the complete abortion in about 95% of pregnancies up to 9 gestational weeks.…”

Section: Introductionmentioning

confidence: 99%

A Simple Procedure for Termination of Pregnancy in the Late First Trimester with Mifeprostone and Misoprostol

Joensuu-Manninen¹,

Nissi²,

Santala³

et al. 2015

OJOG

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Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 -12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristone and after 24 -36 hours they applied 800 µg vaginal misoprostol to medically terminate pregnancy. If the products of conception did not pass, three further doses of 400 µg misoprostol were given vaginally at three hours intervals to medically terminate pregnancy. Results: Of the 116 patients undergoing the procedure 104 (90%) aborted completely. Half of the patients aborted within 6 hours. After medical termination, five per cent of the women were treated because of infection, and five per cent needed a revisit to hospital because of excessive bleeding. Two women received a blood transfusion. Previous live births or previous inducted abortion is presented in the study results. Conclusions: Medical abortion at 9 -12 weeks' gestation is a safe alternative to surgery.

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Medical methods for first trimester abortion

Abstract: Analysis 13.1. Comparison 13 prostaglandin alone vs combined regimen (all), Outcome 1 failure to achieve complete abortion.... Analysis 13.2. Comparison 13 prostaglandin alone vs combined regimen (all), Outcome 2 side e ects.

Cited by 148 publications

References 88 publications

A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy

A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy

Therapeutic abortion in Siriraj Hospital: A 10-year review

A Simple Procedure for Termination of Pregnancy in the Late First Trimester with Mifeprostone and Misoprostol

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