Mifepristone and Oral, Vaginal, or Sublingual Misoprostol for Second-Trimester Abortion

Dickinson, Jan E.; Jennings, Belinda; Doherty, Dorota

doi:10.1097/aog.0000000000000290

Cited by 36 publications

(34 citation statements)

References 16 publications

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“…There was no difference in the prevalence of gastrointestinal side effects between the two groups. Nearly all the women in our study aborted before 24 h like in other similar studies conducted by Elami et al [5], Dickinson et al [6], Borgatta and Kapp [7] reported a success rate of 95 % within 24 h. In our study, the success rate was 89 % in Group-I and 96 % in Group-II (Table 1). …”

Section: Discussionsupporting

confidence: 84%

“…A detailed history was taken, clinical examination including gynecological examination and ultrasonography was performed. The inclusion criteria were: (1) women aged more than 18 Years, (2) singleton pregnancy, (3) closed cervical os, (4) no vaginal bleeding, (5) a legal indication for termination of pregnancy and official approval, (6) willing to follow the study protocol and provide informed consent and (7) willing to undergo required follow-up and surgical management when indicated.…”

Section: Methodsmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 84%

Section: Methodsmentioning

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 low rates of side effects and short bleeding period observed in our study is likely attributable to our use of a low dosage, and perhaps also to the sublingual administration route employed. Sublingual administration of misoprostol is advantageous in that it precludes the inconvenience of vaginal administration and also avoids the first‐pass liver effects that are associated with oral administration, while enabling rapid pregnancy termination …”

Section: Discussionmentioning

confidence: 99%

Early medical abortion with self‐administered low‐dose mifepristone in combination with misoprostol

Song

Tang

et al. 2018

J of Obstet and Gynaecol

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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.

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“…Even though oral administration is appealing for several reasons like convenient and lack of invasiveness, vaginal route seems to be more advantageous (Dickinson JE, 2014). 7 Another study by Elami-Suzin compares the efficacy of mifepristone plus misoprostol and mifepristone plus oxytocin; also confirms vaginal misoprostol has least side effects and convenient.…”

Section: Discussionmentioning

confidence: 99%

“…7 Another study by Elami-Suzin compares the efficacy of mifepristone plus misoprostol and mifepristone plus oxytocin; also confirms vaginal misoprostol has least side effects and convenient. 8 A study by MacIsaac revealed the absorption kinetics of misoprostol with a dose of 400 µgms compared between oral administration and vaginal treatment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Vaginal Misoprostol in Second Trimester Abortion

Geetha¹,

Seethalakshmi²

2017

jemds

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BACKGROUNDTermination of pregnancy has been legalised in India in 1971, mainly to prevent the complications of illegal abortions. Surgical methods of termination in second trimester are not without maternal risks and complications. A search for safer and easier methods of termination of pregnancy prompted by numerous potential complications has resulted in various medical approaches. Hence, prostaglandins were thought to be the answer. Using vaginal misoprostol was cheaper and more effective compared to other methods.The aim of this study was to study the safety and efficacy of vaginal misoprostol in second trimester termination of pregnancy. MATERIALS AND METHODSThis is a study involving 75 patients who attended the OBG OPD for second trimester termination between the period of 2007 and 2012 with the inclusion criteria of singleton pregnancy in both nulliparous and multiparous patients with gestational age between 14 and 24 weeks using 400 micrograms to 1200 micrograms of vaginal misoprostol. RESULTSThe present study further documents the positive experience on the safety and efficacy of misoprostol (PG E1 analogue) in the vaginal route in inducing second trimester abortion. CONCLUSIONMisoprostol is really a wonder drug with safety and efficacy in achieving the second trimester abortion by medical methods, costeffective and easy to administer with minimal side effects. -05-2017, Peer Review 17-06-2017, Acceptance 20-06-2017, Published 24-06-2017. Corresponding Author: Geetha K, #18/A, Elaikara Street, Karaikal-609602. E-mail: vemsrigeenan3@gmail.com DOI: 10.14260/jemds/2017 Surgical methods in second trimester are not without medical risks and complications. So there is a need for alternate methods of termination of pregnancy, preferably medical methods without any risks or at least with minimal complications, easy and inexpensive. Use of prostaglandin analogue E1 could be the right choice now. KEYWORDS ObjectiveThe aim of this study is to evaluate the efficacy and safety of vaginal misoprostol in second trimester abortion in both nulliparous and multigravida with anomaly baby, dead foetus due to failure of contraception or due to other medical causes. MATERIALS AND METHODSThis is a descriptive hospital-based study design involving 75 patients attending the outpatient department for second trimester pregnancy fulfilling the inclusion criteria. Inclusion Criteria

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Mifepristone and Oral, Vaginal, or Sublingual Misoprostol for Second-Trimester Abortion

Abstract: I.

Cited by 36 publications

References 16 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

Early medical abortion with self‐administered low‐dose mifepristone in combination with misoprostol

Efficacy and Safety of Vaginal Misoprostol in Second Trimester Abortion

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