Human Reproduction, Vol. 8, No. 9, pp. 1502-1505, 1993
© 1993 European Society of Human Reproduction and Embryology
research-article |
Pregnancy: The effect of dose of mifepristone and gestation on the efficacy of medical abortion with mifepristone and misoprostol
Department of Obstetrics and Gynaecology, Centre for Reproductive Biology, University of Edinburgh 37 Chalmers Street, Edinburgh EH3 9EW, UK
Although it has been demonstrated that a combination of mifepristone and a prostaglandin is an effective method of inducing abortion in early pregnancy, the optimum dose of the antigestogen is unknown. Women (n = 220) requesting abortion in early pregnancy (
63 days amenorrhoea) were randomized to receive a single dose of either 600 or 200 mg mifepristone followed 48 h later by a single dose of 600 µg misoprostol by mouth. The percentage of women who had a complete abortion (93.6% confidence interval 90.4–95.5%) was identical in the two groups. There was no significant difference in the number of women who passed the fetus within 4 h of receiving the prostaglandin (64 versus 74%), the days of bleeding (14.6 ± 1.1 versus 15.3 ± 0.9) nor in the onset of the next period (39.7 ± 1.3 versus 36.7 ± 1.3) respectively between the groups receiving 200 or 600 mg mifepristone. However, the complete abortion rate was significantly higher in women 49 days compared to women 50–63 days amenorrhoea (97.5 versus 89.1% respectively; P < 0.02). There was no difference in any of the other parameters at different weeks of gestation. We conclude: (i) that the recommended dose of mifepristone could be reduced from 600 to 200 mg without loss of clinical efficacy, (ii) that the combination of mifepristone and 600 µg misoprostol is a highly effective alternative to vacuum aspiration for inducing abortion in women < 50 days amenorrhoea and (iii) at gestation >56 days, this combination may result in too many incomplete abortions to be clinically acceptable.
Key words: gestation/medical abortion/mifepristone/misoprostol
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. Saav, A. Aronsson, L. Marions, O. Stephansson, and K. Gemzell-Danielsson Cervical priming with sublingual misoprostol prior to insertion of an intrauterine device in nulliparous women: a randomized controlled trial Hum. Reprod., October 1, 2007; 22(10): 2647 - 2652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Aronsson, C. Fiala, O. Stephansson, F. Granath, B. Watzer, H. Schweer, and K. Gemzell-Danielsson Pharmacokinetic profiles up to 12 h after administration of vaginal, sublingual and slow-release oral misoprostol Hum. Reprod., July 1, 2007; 22(7): 1912 - 1918. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Grimes and M. D. Creinin Induced Abortion: An Overview for Internists Ann Intern Med, April 20, 2004; 140(8): 620 - 626. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Aronsson, M. Bygdeman, and K. Gemzell-Danielsson Effects of misoprostol on uterine contractility following different routes of administration Hum. Reprod., January 1, 2004; 19(1): 81 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Rorbye, M. Norgaard, and L. Nilas Prediction of late failure after medical abortion from serial {beta}-hCG measurements and ultrasonography Hum. Reprod., January 1, 2004; 19(1): 85 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. S. Tang, C. C.W. Chan, E. H.Y. Ng, S. W.H. Lee, and P. C. Ho A prospective, randomized, placebo-controlled trial on the use of mifepristone with sublingual or vaginal misoprostol for medical abortions of less than 9 weeks gestation Hum. Reprod., November 1, 2003; 18(11): 2315 - 2318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. S. Tang, J. Xu, L. Cheng, S. W.H. Lee, and P. C. Ho Pilot study on the use of sublingual misoprostol with mifepristone in termination of first trimester pregnancy up to 9 weeks gestation Hum. Reprod., July 1, 2002; 17(7): 1738 - 1740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W. Ashok, A. Kidd, G. M.M. Flett, A. Fitzmaurice, W. Graham, and A. Templeton A randomized comparison of medical abortion and surgical vacuum aspiration at 10-13 weeks gestation Hum. Reprod., January 1, 2002; 17(1): 92 - 98. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bartley, A. Brown, R. Elton, and D. T. Baird Double-blind randomized trial of mifepristone in combination with vaginal gemeprost or misoprostol for induction of abortion up to 63 days gestation Hum. Reprod., October 1, 2001; 16(10): 2098 - 2102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. B. Goldberg, M. B. Greenberg, and P. D. Darney Misoprostol and Pregnancy N. Engl. J. Med., January 4, 2001; 344(1): 38 - 47. [Full Text] [PDF]
|
|
|
|
 |
|
 F. C. Denison, S. C. Riley, C. L. Elliott, R. W. Kelly, A. A. Calder, and H. O.D. Critchley The effect of mifepristone administration on leukocyte populations, matrix metalloproteinases and inflammatory mediators in the first trimester cervix Mol. Hum. Reprod., June 1, 2000; 6(6): 541 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Christin-Maitre, P. Bouchard, and I. M. Spitz Medical Termination of Pregnancy N. Engl. J. Med., March 30, 2000; 342(13): 946 - 956. [Full Text] [PDF]
|
|
|
|
|
|
I. M. Spitz, C. W. Bardin, L. Benton, and A. Robbins Early Pregnancy Termination with Mifepristone and Misoprostol in the United States N. Engl. J. Med., April 30, 1998; 338(18): 1241 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Termination of first trimester pregnancy DTB, February 1, 1998; 36(2): 13 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. El-Refaey, D. Rajasekar, M. Abdalla, L. Calder, and A. Templeton Induction of Abortion with Mifepristone (RU 486) and Oral or Vaginal Misoprostol N. Engl. J. Med., April 13, 1995; 332(15): 983 - 987. [Abstract] [Full Text] [PDF]
|
|