Misoprostol Administered by Epithelial Routes

Meckstroth, Karen R.; Whitaker, Amy K.; Bertisch, Suzanne M.; Goldberg, Alisa B.; Darney, Philip D.

doi:10.1097/01.aog.0000230398.32794.9d

Cited by 103 publications

(81 citation statements)

References 22 publications

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“…Drug related side effects and procedure related complications were very low, which is comparable to different studies. 9,13,15 In present prospective study 98% women aborted within 16 hours, which is comparable to about ninety percent as reported by other studies.…”

Section: Discussionsupporting

confidence: 87%

“…Vaginal route had been found to be more promising than oral route probably due to an accumulating plasma level with fewer gastrointestinal side effects. [9][10][11] In such a context, we found this regime of vaginal administration of 0.5mg of dinoprostone gel (PGE1) followed by 400µg misoprostol 4 hourly very effective for second trimester pregnancy termination. Mean induction abortion interval in our study was 12.58±1.02 hours which is comparable to 12-16 hours in other studies and with better induction to interval time.…”

Section: Discussionmentioning

confidence: 99%

“…8 However vaginal route is associated with slower peak level achievement, but the effect lasts longer with fewer side effects. 9 Prostaglandin E2 gel was used for cervical ripening before induction of labor in patient having low bishop score. Studies and result indicate that local prostaglandin E2 is superior to placebo or no therapy in enhancing cervical effacement and dilation, reducing initial induction failures, shortening the induction-delivery interval, decreasing oxytocin use.…”

Section: Introductionmentioning

confidence: 99%

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Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

Kumar¹,

Agarwal

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONSecond trimester termination contributes approximately 10% to 20% of all induced abortions cases and about 65% to 70% of all fatal complications are related to induced abortions. Various agents are used to ripen the cervix and stimulate uterine contractions and induce abortion after 12 weeks, but available data regarding their safety and effectiveness are limited.1,2 Various agents include hypertonic saline, or hyperosmolar urea, injected intra-amniotically; ethacridine lactate administered intraor extra-amniotically; prostaglandin analogues administered parenterally or intra-or extra-amniotically; and oxytocin injected intravenously or intramuscularly. These methods and routes of administration, however, are invasive and likely to be less safe, and the time to complete abortion is longer when compared to the use of methods such as misoprostol alone, combined dinoprostone and misoprostol combined mifepristone and misoprostol.2-5 Second trimester abortion also includes surgical procedure, but it can result in complications like uterine perforation, cervical incompetence, uterine ABSTRACT Background: The addition of dinoprostone gel (PGE2) to standard regimen of second trimester abortion using vaginal misoprostol (PGE1) reduces failure rate and decrease induction abortion time interval. We evaluated the role and efficacy of vaginal dinoprostone gel with vaginal misoprostol in women undergoing second trimester abortion. Objective of present study was to assess the safety and effectiveness of vaginal dinoprostone gel plus vaginal misoprostol for second trimester termination of pregnancy. Methods: This study was a prospective cohort involving 100 women with 12-20 weeks gestation requesting termination of pregnancy. In study group 0.5mg dinoprostone gel applied vaginally followed by 400µg misoprostol every four hourly (max 3 doses) after six hours of dinoprostone gel application. The mean age of the women study was 27.2 years and mean gestational age was 18.9 weeks. The primary effectiveness of the study was the efficacy of the treatment to terminate pregnancy at 20 hrs. Secondary outcomes were induction abortion interval, failure rate, side effects. statistical analysis of study was carried out using chi square test. Results: At 20 hours, the complete abortion rate was 100%. Within 16 hours 98% women aborted without any significant side effects. Mean induction abortion interval was 14.56 hours. Conclusions: Combination of vaginal dinoprostone gel (PGE2) plus misoprostol (PGE1) is effective, safe and alternate method for second trimester pregnancy termination with. In this protocol induction to abortion interval time is less as compared to other methods of second trimester pregnancy termination.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

Kumar¹,

Agarwal

2018

Int J Reprod Contracept Obstet Gynecol

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“…Ayrıca uygulama yönte-minden bağımsız olarak misoprostolün etkisinin geç başladığı bildirilmiş ve klinik kullanımda bu gecikmenin unutulmaması gerektiği belirtilmiştir. Etkisi oral ve sublingual uygulamada daha hızlı başlar, rektal ve vajinal uygulamada daha uzun etkilidir (27) . Postpartum kanamanın önlenmesi ve tedavisi ile ilgili önerilerin yer aldığı Dünya Sağlık Örgütü kılavu-zunda postpartum kanama tedavisinde misoprostolün sublingual yol ile uygulanması önerilmektedir (2) .…”

Section: Yönetimunclassified

The prevention and management of postpartum hemorrhage

Kaya¹,

Sezer²

2017

IKSST

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“…[13][14][15] Due to its rapid absorption, sublingual route reaches its peak concentration in a short time and has the highest bioavailability. Vaginal route causes prolonged regular uterine contractions and has fewer side effects after administration.…”

Section: Introductionmentioning

confidence: 99%