A randomised study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy

Abstract

Objective To compare the effectiveness of gemeprost and misoprostol as prostaglandins used in combination with mifepristone for induction of mid-trimester termination. Design Randomised trial.Setting Scottish teaching hospital.Sample One hundred women undergoing abortion between 12 and 20 weeks.Methods Each woman received 200 mg mifepristone and 36-48 hours later either 1 mg gemeprost vaginal pessary every 6 hours for 18 hours or 4 Â 200 Ag misoprostol tablets vaginally followed by 2 Â 200 Ag misoprostol tablets orally every 3 hours for 12 hours. Success was defined as the percentage of women aborted within 24 hours of the first administration of prostaglandin. Main outcome measures Prostaglandin -abortion interval and side effects.Results There were no significant differences in median prostaglandin -abortion interval between gemeprost (6.6 hours 95% CI 6.0-10.7) and misoprostol (6.1 hours 95% CI 5.5-7.5) ( P ¼ 0.22). The cumulative abortion rates at 24 hours (96% vs 94%, respectively), the surgical evacuation rates (12% and 10%) and the incidence of vomiting, diarrhoea and pain were similar. Conclusion Two hundred milligrammes of mifepristone followed 36 -48 hours later by either vaginal gemeprost or misoprostol is a highly effective way of inducing abortion in the second trimester of pregnancy.

One- and two-day mifepristone-misoprostol intervals for second trimester termination of pregnancy between 13 and 16 weeks of gestation

“…Based on a previous study [10], to achieve an 80% power to detect a difference of less than 6% in the efficacy of the two methods and to allow completion of the recruitment in time, a minimum of 100 patients were needed (50 in each group).…”

Mifepristone‐ and misoprostol‐induced mid‐trimester termination of pregnancy: A review of 272 cases

“…[7][8][9] The manufacturer's recommendation is to use 600 mg of mifepristone, but randomised controlled trials have shown that 200 mg of mifepristone is as effective as 600 mg. [10][11][12] The use of prostaglandins has been well studied in relation to dose, type and route of administration. [13][14][15][16][17][18][19] Misoprostol is cheap, does not require special storage conditions and is as effective as gemeprost 14,20 and prostaglandin E 2 21 in mid-trimester abortion. Gemeprost is no longer obtainable in New Zealand.…”

Interruptions médicales de grossesse et morts fœtales in utero après 14 semaines d’aménorrhée : quel protocole de déclenchement en 2010 ? Revue de la littérature

“…Les résultats combinés de six études randomisées [25][26][27][28][29][30] regroupant plus de 450 femmes permettent de montrer qu'il n'y a pas de différence significative entre les taux d'expulsion à 24 heures, ainsi qu'entre le délai moyen entre le début de l'induction et l'expulsion. En revanche, il existe une différence significative en termes de dose d'analgésique utilisée et le taux d'expulsion incomplète.…”