Mifepristone versus vaginally administered misoprostol for cervical priming before first-trimester termination of pregnancy: A randomized, controlled study

Ashok, Premila Wencesiaus; Flett, Gillian; Templeton, Allan

doi:10.1067/mob.2000.106767

Cited by 49 publications

(43 citation statements)

References 17 publications

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“…Mifepristone, taken orally 24-48 hours prior to first trimester surgical abortion, has been shown to be as effective as gemeprost 50 and more effective than vaginal misoprostol 51 at ripening the cervix. Some surgeons exploit the priming effect of mifepristone before D&E, even preferring it to misoprostol (C Paterson, personal communication, 26 June 2008).…”

Section: Cervical Preparationmentioning

confidence: 99%

Surgical Abortion in the Second Trimester

Lohr¹

2008

Reproductive Health Matters

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Section: Cervical Preparationmentioning

confidence: 99%

Surgical Abortion in the Second Trimester

Lohr¹

2008

Reproductive Health Matters

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“…It has been demonstrated that the maximal sensitivity is achieved when mifepristone is administered 36-48 hours before the prostaglandin analogue, 7 and this is also the time interval to achieve maximal softening and dilation of the uterine cervix. 8 Consequently, the 36-to 48-hour interval was adopted as a standard for the medical abortion regimen. Also, the data collected on 16 000 women who had been treated with 600 mg of mifepristone followed by a prostaglandin analogue 24-72 hours later suggested that the efficacy was highest if the interval was 48 hours.…”

Section: Introductionmentioning

confidence: 99%

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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“…Animal studies showed that mifepristone induces collagen remodelling. It caused a decrease in collagen organisation with decreased fibril length and diameter [32]. The prostaglandin analogue, misoprostol, is more commonly used in this indication because it is cheaper and largely available.…”

Section: Introductionmentioning

confidence: 99%