Low-dose mifepristone 200 mg and vaginal misoprostol for abortion

Schaff, Eric A.; Eisinger, Steven H.; Stadalius, Lisa S.; Franks, Peter; B, Gore; Poppema, Suzanne

doi:10.1016/s0010-7824(98)00150-4

Cited by 180 publications

(110 citation statements)

References 15 publications

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“…However, successful self-administration of vaginal misoprostol at home and in hospital prior to medical termination of pregnancy has been reported in the literature. [38][39][40][41][42] It has previously been suggested that women of different cultural and ethnic backgrounds might have a completely different view regarding self-administration, 37 although our study does not support this view. It has been estimated that there are a large number of women at risk of not receiving a cervical priming agent pre-operatively in England and Wales.…”

Section: Discussioncontrasting

confidence: 91%

Fertility control: Oral versus self‐administered vaginal misoprostol at home before surgical termination of pregnancy: a randomised controlled trial

Oppegaard

Qvigstad

Nesheim

2005

BJOG

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Objective To compare the impact of 400 mg oral versus selfadministered vaginal misoprostol at home on pre-operative cervical priming in both primigravid and multigravid women prior to first trimester surgical abortion.Design Randomised controlled trial.Setting Norwegian University Teaching Hospital.Sample Three hundred and thirty-eight women undergoing surgical abortion between 7 and 12 weeks of gestation.Methods The women were randomised to either 400 mg of oral misoprostol the evening before or 400-mg of self-administered vaginal misoprostol at home the same day as vacuum aspiration.Main outcome measures Pre-operative cervical dilatation, complications and acceptability.Results The median cervical dilatation was 6.2 mm (range 0-11 mm) for the women in the 400 mg oral misoprostol and 6.5 mm (range 0-11 mm) in the 400-mg vaginal misoprostol groups. The median pre-operative dilatation was larger in multigravidae (6.4 and 6.7 mm for the oral and vaginal routes, respectively) than in primigravidae (5.8 and 6.0 mm, respectively). In primigravidae, 19% achieved a pre-operative dilatation of ‡7 mm, with no significant difference between oral and vaginal dosage. In multigravidae, 52% achieved a pre-operative dilatation of ‡7 mm with vaginal dosage, compared with 36% with oral dosage (P = 0.03). There was no difference between non-immigrant versus immigrant women in pre-operative cervical dilatation. The 400-mg oral dosage group had a higher risk of bleeding, compared with the group receiving 400-mg vaginal misoprostol [odds ratio (OR) = 10.4; confidence interval (CI) 5.2-20.8]. There was no difference between non-immigrant and immigrant women in acceptability of self-administered vaginal misoprostol; almost all women found this administration route acceptable. Complications were minor and were distributed equally between the two dosage groups. ConclusionsThe vaginal route will result in a satisfactory dilatation in about half of multigravidae but is much less effective in primigravidae. The oral route does not lead to satisfactory dilatation in either group and is associated with a higher occurrence of pre-operative bleeding. Self-administered vaginal misoprostol at home is highly acceptable.

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Section: Discussioncontrasting

confidence: 91%

Fertility control: Oral versus self‐administered vaginal misoprostol at home before surgical termination of pregnancy: a randomised controlled trial

Oppegaard

Qvigstad

Nesheim

2005

BJOG

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“…11 Scaff et al, the advantage of medical abortion is that it has high efficacy at gestational age ≤49 days. 13 This study emphasizes on proper selection of patients by using various inclusion and exclusion criteria. The advantage of study protocol is that the patient is in constant supervision of the doctor.…”

Section: Discussionmentioning

confidence: 99%

Medical methods of abortion using lowest effective dose of mifepristone and misoprostol: case study of 100 women

Anjum

Nivedita

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Medical abortion or Medical Methods of abortion (MMA) (or Chemical abortion) is defined as “the non-surgical way of termination of termination of pregnancy by a drug or combination of drugs”. With introduction of MMA there has been a steep rise in abortion related complications due to irrational use of these drugs. This study is undertaken using lowest effective dose of mifepristone and misoprostol in 100 women willing for termination of pregnancy with period of gestation <49 days to study the efficacy, side effects and failure rate. Present study emphasizes on using MMA by proper selection of patient, adhering to proper schedule under provision of MTP Act (counselling, consent, examination, confirmation of pregnancy, prescription by a registered medical practioner) in order to enhance efficacy and avoid complications.Methods: Prospective Clinical Study consist of use of single dose of 200mg of mifepristone orally followed by misoprostol (400µg) by vaginal route for terminating pregnancy in ≤49 days of gestation. Statistical analysis done by Chi square test.Results: In this study, success rate i.e. complete abortion without requiring surgical procedure was 96%and failure rate was 4%. Nausea (56%) is the most common side effect of Mifepristone. Chills (33%) is the most common side effect of Misoprostol. Mean Induction Abortion Interval is 2.17±1.2 hrs. Mean Duration of Bleeding is 7.79±4.42 days.Conclusions: Medical abortion is a promising method of early abortion in a developing country like India as it requires no technical skills and manpower with a good safety profile.

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“…Information on LTFU rates in medical abortion literature are derived from clinical trials and are highly variable due to differences in medication administration protocol, follow-up methods and timing, patient population and laws, as well as whether the data were collected prospectively or retrospectively. Most clinical trials report LTFU rates below 5% [6,[11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of medical abortion follow-up with serum human chorionic gonadotropin testing and in-office assessment

et al. 2012

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Low-dose mifepristone 200 mg and vaginal misoprostol for abortion

Cited by 180 publications

References 15 publications

Fertility control: Oral versus self‐administered vaginal misoprostol at home before surgical termination of pregnancy: a randomised controlled trial

Fertility control: Oral versus self‐administered vaginal misoprostol at home before surgical termination of pregnancy: a randomised controlled trial

Medical methods of abortion using lowest effective dose of mifepristone and misoprostol: case study of 100 women

Comparison of medical abortion follow-up with serum human chorionic gonadotropin testing and in-office assessment

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