Randomized trial of oral versus sublingual misoprostol 24 h after mifepristone for medical abortion

Dahiya, Kiran; Mann, Sonika; Nanda, Smiti

doi:10.1007/s00404-010-1590-2

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…The combination of mifepristone and misoprostol has been found to be the most effective for abortion than the use of misoprostol alone or the use of another regimen. 4,12,16,[40][41][42][43][44][45] There is strong evidence supporting the use of mifepristone-misoprostol combination as an efficient regimen for medical abortion up to 70 days of gestation, and it has been approved by the US Food and Drug Administration. 20,46,47 On the other hand, there is no absolute lower gestational age limit.…”

Section: Combination Of Mifepristone and Misoprostolmentioning

confidence: 99%

“…12 Misoprostol presents many advantages, including the fact that it is stable at room temperature, has fewer systemic adverse effects compared with other prostaglandins, and is inexpensive. 4,[12][13][14][15] Misoprostol's uterotonic properties, including ripening and dilatation of the cervix and myometrial contractions, make it ideal for medical abortion, especially in developing countries because of its low cost. 4,16 Mifepristone (previously known as RU 486) is a synthetic steroid with strong antiprogester-1 activity, originally established for its potential antiglucocorticoid activity.…”

mentioning

confidence: 99%

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Combination of Mifepristone and Misoprostol for First-Trimester Medical Abortion: A Comprehensive Review of the Literature

Kelesidou,

Tsakiridis,

Virgiliou

et al. 2024

Obstetrical &Amp; Gynecological Survey

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Importance Several medications have been used to achieve medical abortion in the first trimester of pregnancy. The most commonly used is the combination of mifepristone and misoprostol; however, different doses and routes of administration have been proposed. Objective The aim of this study was to summarize published data on the effectiveness, adverse effects, and acceptability of the various combinations of mifepristone and misoprostol in medical abortion protocols in the first trimester of pregnancy. Evidence Acquisition This was a comprehensive review, synthesizing the findings of the literature on the current use of mifepristone and misoprostol for first-trimester abortion. Results The combination of mifepristone and misoprostol seems to be more effective than misoprostol alone. Regarding the dosages and routes, mifepristone is administered orally, and the optimal dose is 200 mg. The route of administration of misoprostol varies; the sublingual and buccal routes are more effective; however, the vaginal route (800 μg) is associated with fewer adverse effects. Finally, the acceptability rates did not differ significantly. Conclusions Different schemes for first-trimester medical abortion have been described so far. Future research needs to focus on identifying the method that offers the best trade-off between efficacy and safety in first-trimester medical abortion. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After participating in this activity, the learner should be better able to discuss available combinations of mifepristone and misoprostol for first-trimester medical abortion; describe the recommended doses of misoprostol for first-trimester medical abortion; and assess the adverse effects caused by misoprostol when administered by different routes.

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Section: Combination Of Mifepristone and Misoprostolmentioning

confidence: 99%

mentioning

confidence: 99%

Combination of Mifepristone and Misoprostol for First-Trimester Medical Abortion: A Comprehensive Review of the Literature

Kelesidou,

Tsakiridis,

Virgiliou

et al. 2024

Obstetrical &Amp; Gynecological Survey

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“…f. Misoprostol oral versus sublingual [34,35] Two trials compared 400 μg misoprostol oral versus sublingual routes in combined regimens. Women treated with the oral route had lower rates of ongoing pregnancy (RR 0.44 CI 95% 0.10-1.96) and…”

Section: Misoprostol Buccal Versus Vaginal [32]mentioning

confidence: 99%

Medical termination for pregnancy in early first trimester (≤ 63 days): a systematic review

Abubeker

Lavelanet

Rodríguez

et al. 2019

Preprint

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Background A wide range of drugs have been studied for first trimester medical abortion. Studies evaluating different regimens, including combination mifepristone and misoprostol and misoprostol alone regimens, show varying results related to safety, efficacy and other outcomes. Objectives To compare the safety, effectiveness and acceptability of medical abortion and to compare medical methods with surgical methods of abortion ≤ 63 days of gestation. Methods Pubmed and EMBASE were systematically searched from inception through January 2019 using a combination of MeSH, keywords and text words. Randomized controlled trials on induced abortion at ≤ 63 days that compared different regimens of medical abortion using mifepristone and/or misoprostol and trials that compared medical with surgical methods of abortion were included. We extracted data into a pre‐designed form, calculated effect estimates, and performed meta‐analyses where possible. The primary outcomes were ongoing pregnancy and successful abortion. Results Combined regimens using mifepristone and misoprostol had lower rates of ongoing pregnancy and higher rates of successful abortion compared to misoprostol only regimen. Conclusion In this systematic review, we establish medical methods of abortion utilizing combination mifepristone/misoprostol or misoprostol alone are effective, safe and acceptable. In combined regimen, misoprostol 800 μg given vaginally or sublingually had lower rates of ongoing pregnancy and higher rates of successful abortion with moderate certainty of evidence.

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“…8 According to Dahiya et al sublingual Misoprostol is as effective as oral Misoprostol 48 hours after administration of 200 mg Mifepristone. 9 According to Sahu RR et al following oral administration, the plasma concentration increased rapidly with a peak of 30 min, declined rapidly by 120 min, and remained low thereafter. 10 In contrast, after vaginal administration, the plasma concentration gradually increased, reaching maximum levels after 70-80 min and slowly declined with detectable levels present after 6 hour.…”

Section: Misoprostolmentioning

confidence: 99%

Comparison between sublingual 600 and 800 microgram misoprostol after mifepristone for MTP up to 9 weeks gestation

Thakur

Pratap

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of the present study was to compare the efficacy between sublingual 600 and 800 microgram Misoprostol after administration of Mifepristone up to 9 weeks gestation, to compare the incidence of side effects between the two doses. To compare the acceptability between the two doses.Methods: This study is a single-center, randomized study. The study is conducted at Fortis Escorts Hospital and Research Centre, Faridabad, during period of May 2014 to June 2015. 160 Pregnant women with singleton pregnancy up to 9 weeks gestation, visiting OPD of Obstetrics and Gynaecology, who wanted MTP by drug, after taking care of inclusion and exclusion criteria. An informed consent was taken from all the women.Results: In terms of efficacy, both the groups were comparable (p value 0.509). Blood loss was comparable in both the groups (p value 0.147). In terms of side effects, itching and rashes (p value 0.004) and abdominal cramps (p value 0.001) was found to be more in women taking 800ug Misoprostol. Also, need for analgesia (p value 0.001) was found to be more in women taking 800ug Misoprostol.Conclusions: Sublingual Misoprostol is comfortable and easier administration when compared to other routes and it has potential to be developed as a self-administered regimen. 600ug Sublingual Misoprostol is as efficacious as 800ug sublingual Misoprostol with significantly lesser side effects up to 7 weeks of gestation.

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Randomized trial of oral versus sublingual misoprostol 24 h after mifepristone for medical abortion

Abstract: It is concluded that 400 μg of sublingual misoprostol is as effective as oral misoprostol 24 h after mifepristone for medical abortion of ≤ 56 days.

Cited by 14 publications

References 18 publications

Combination of Mifepristone and Misoprostol for First-Trimester Medical Abortion: A Comprehensive Review of the Literature

Combination of Mifepristone and Misoprostol for First-Trimester Medical Abortion: A Comprehensive Review of the Literature

Medical termination for pregnancy in early first trimester (≤ 63 days): a systematic review

Comparison between sublingual 600 and 800 microgram misoprostol after mifepristone for MTP up to 9 weeks gestation

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