Effects of misoprostol on uterine contractility following different routes of administration

Aronsson, Annette; Bygdeman, M.; Gemzell‐Danielsson, Kristina

doi:10.1093/humrep/deh005

Cited by 104 publications

(75 citation statements)

References 12 publications

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“…This study suggests that 100 mg dose may not be enough if the dose of misoprostol is insufficient and/or effective uterine contractions fail to be produced by the route it is administered. 15 When mifepristone dose was lowered to 50 mg in a regimen with 1 mg of gemeprost, complete abortion rate was 89.8%, while it was 92.9% in the 200 mg group. 5 The rate of continuing pregnancies was also higher (2.2 versus 0.6%) in the 50 mg group.…”

Section: Discussionmentioning

confidence: 96%

Two mifepristone doses and two intervals of misoprostol administration for termination of early pregnancy: a randomised factorial controlled equivalence trial*

Hertzen¹,

Piaggio²,

Wojdyla³

et al. 2009

BJOG

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Objective To compare the efficacy of 100 mg and 200 mg of mifepristone and 24-and 48-hour intervals to administration of 800mg vaginal misoprostol for termination of early pregnancy.Design Placebo-controlled, randomized, equivalence trial, stratified by centre.Setting 13 departments of obstetrics and gynecology in nine countries.Population 2181 women with 63 days or less gestation requesting medical abortion.Methods Two-sided 95% CI for the risk differences of failure to complete abortion were calculated and compared with 5% equivalence margin between two doses of mifepristone and two intervals to misoprostol administration. Proportions of women with adverse effects were compared between the regimens using standard testes for proportions.Outcome measures Rates of complete abortion without surgical intervention and adverse effects associated with the regimens.Results Efficacy outcome was analysed for 2126 women (97.5%) excluding 55 lost to follow up. Both mifepristone doses were found to be similar in efficacy. The rate of complete abortion was 92.0% for women assigned 100 mg of mifepristone and 93.2% for women assigned 200 mg of mifepristone (difference 1.2%, 95% CI: -1.0 to 3.5). Equivalence was also evident for the two intervals of administration: the rate of complete abortion was 93.5% for 24-hour interval and 91.7% for the 48-hour interval (difference -1.8%, 95% CI: -4.0 to 0.5). Interaction between doses and interval to misoprostol administration was not significant (P = 0.92). Adverse effects related to treatments did not differ between the groups.Conclusions Both the 100 and 200 mg doses of mifepristone and the 24-and 48-hour intervals have a similar efficacy to achieve complete abortion in early pregnancy when mifepristone is followed by 800 micrograms of vaginally administered misoprostol.

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Section: Discussionmentioning

confidence: 96%

Two mifepristone doses and two intervals of misoprostol administration for termination of early pregnancy: a randomised factorial controlled equivalence trial*

Hertzen¹,

Piaggio²,

Wojdyla³

et al. 2009

BJOG

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“…Of those with a successful vaginal delivery, 74% delivered within 24 hours. 4 In Varsha et al, a majority (96%, n=241) of mothers went into labour but 4% had failed induction. 10 In this study mean induction delivery interval was 11.44 hours.…”

Section: Discussionmentioning

confidence: 96%

“…These properties make misoprostol an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. 3,4 In 2007, the WHO Expert Committee on the Selection and Use of Essential Medicines included misoprostol 25µg tablets to its list and this inclusion will hopefully enable the national essential lists to include low-dose misoprostol for labour induction. 5 In this study Tab.…”

Section: Introductionmentioning

confidence: 99%

An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Prajapati

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Labour induction is a clinical intervention that has the potential to confer major benefits to the mother and new born when continuation of pregnancy poses a risk/danger to the outcome of pregnancy. Misoprostol is an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. It is stable at room temperature, relatively inexpensive and can be given via several routes (oral, vaginal, sublingual, and buccal).Methods: It is an observational study of 100 cases conducted in the labour room of a Tertiary Care Government Hospital, Rajkot over a span from January 2016 to March 2017. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. Tablet misoprostol 25 microgram given orally every 4 hourly with maximum of 5 doses till the patient was in active stage of labour.Results: Maximum patients delivered by a single dose of Tab. Misoprostol (35%), the mean induction delivery interval was 11.44 hours. Most of the women delivered by vaginal route (88%) without any maternal complications like PPH, cervical/vaginal tear and uterine rupture. Only 4 cases out of 100 of failed induction for which LSCS was taken. Eight babies were admitted in NICU for MSL and had good prognosis. The most common side effect of the drug was nausea (15%) followed by fever and vomiting. 69% patients did not have any adverse drug reaction.Conclusions: Thus, induction of labour with oral misoprostol reduces the LSCS rates, lesser induction delivery interval and has good fetal outcome. The drug is well tolerated by the patients orally and has very few side effects.

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“…Satisfactory cervical priming is achieved in first trimester gestations up to 9 weeks gestation with one misoprostol 200 mcg tablet taken orally. The oral route is preferred to minimise side effects occurring before the woman arrives for surgery, distressing cramping being more likely to occur with the sublingual, buccal or vaginal route (Aronsson et al, 2004). surveyed the number of women making either a phone or an attendance contact with pain and bleeding after surgical termination of a first trimester pregnancy following four different regimens.…”

Section: Misoprostol Cervical Primingmentioning

confidence: 99%

Medical and Surgical Induced Abortion

Chambers¹

2012

From Preconception to Postpartum

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Effects of misoprostol on uterine contractility following different routes of administration

Abstract: Based on recording of uterine activity, sublingual misoprostol acts as rapidly as oral treatment, while development of contractions was similar to that seen following vaginal administration.

Cited by 104 publications

References 12 publications

Two mifepristone doses and two intervals of misoprostol administration for termination of early pregnancy: a randomised factorial controlled equivalence trial*

Two mifepristone doses and two intervals of misoprostol administration for termination of early pregnancy: a randomised factorial controlled equivalence trial*

An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Medical and Surgical Induced Abortion

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