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Hum. Reprod. Advance Access published online on December 1, 2008
Human Reproduction, doi:10.1093/humrep/den425
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A randomized trial to compare two dosing intervals of misoprostol following mifepristone administration in second trimester medical abortion

J. Chai1, O.S. Tang1, Q.Q. Hong1, Q.F. Chen2, L.N. Cheng2, E. Ng1 and P.C. Ho1,3

1 Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong Special Administrative Region, China 2 Shanghai Institute of Family Planning, Technical Instruction, Shanghai, China

3 Correspondence address. E-mail: pcho{at}hkusua.hku.hk

BACKGROUND: The conventional timing of misoprostol administration after mifepristone for second trimester medical abortion is 36–48 h, but simultaneous administration, which may make the regimen more convenient, has not been studied. The objective of this randomized comparison study is to compare two intervals of administration of misoprostol after pretreatment with mifepristone for second trimester medical abortion.

METHODS: Eligible women with gestational age between 12 and 20 weeks were randomized to receive mifepristone 200 mg orally followed by 600 µg misoprostol vaginally either immediately or 36–38 h later, followed by 400 µg vaginal misoprostol every 3 h for a maximum of four doses. The primary outcome measure was the success rate at 24 h after the start of misoprostol treatment and the secondary outcome measures were the induction-to-abortion interval and the frequency of side effects.

RESULTS: There was a significant difference in the success rate at 24 h (36–38 h: 100%; immediate: 91.5%). The median induction-to-abortion interval was significantly shorter in the 36–38 h regimen (4.9 h) compared with the immediate regimen (10 h). Side effects in terms of febrile episodes and chills/rigors were significantly higher in the immediate administration group.

CONCLUSIONS: Simultaneous use of mifepristone and misoprostol for second trimester medical abortion is not as effective as the regimen using a 36–38 h dosing interval.

Key words: mifepristone/misoprostol/second trimester medical abortion

Submitted on September 26, 2008; resubmitted on October 30, 2008; accepted on November 4, 2008.


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