Simultaneous use of mifepristone and misoprostol for early pregnancy termination

Li, Yiu‐Tai; Hsieh, James Ching-Hung; Hou, Guang-Qiong; Chen, Tien-Hui; Chu, Yi-Chih; Lin, Ta-Chin; Kuan, Long-Ching; Lin, Mau; Tang, Hung Jen; Kuo, Tsung-Cheng

doi:10.1016/j.tjog.2010.09.002

Cited by 21 publications

(10 citation statements)

References 14 publications

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“…However in the study by Li YT et al, the mean drug abortion interval was found to be 5.8 hours which is not similar to the results. 8 The side effects in terms of nausea and vomiting were significantly less with buccal route of Misoprostol as compared to vaginal route of Misoprostol. This was found to be similar to the study by Geetika G et al, and also similar to the findings in the study by Alam A et al, Shivering and fever was less in women who took buccal Misoprostol as compared to women taking vaginal Misoprostol.…”

Section: Discussionmentioning

confidence: 90%

Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

Khan¹,

Kant²,

Thukral³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: To compare the effectiveness, side effects, and patient satisfaction of buccal versus vaginal misoprostol administration in first trimester abortions.Methods: Women opting for first trimester abortion received oral Mifepristone followed 48 hours latermisoprostol. Group A received Misoprostol via buccal route whereas group B received Misoprostol vaginally. A comparative analysis using SPSS was done.Results: Giving 800µg Misoprostol by either buccal or vaginal route after oral Mifepristone have comparable efficacy in terms of complete abortion rate (96% in buccal group versus 98% in vaginal group; p value = 0.495), failure rate being statistically similar (4% versus 2%). Drug abortion interval was comparable in the two groups. (11.16 hour in buccal group and 12.32 hours in vaginal group). Few side effects like nausea and vomiting, shivering, diarrohea was significantly higher with vaginal Misoprostol while abdominal cramps, altered taste were found more with the buccal group.Conclusions: Buccal Misoprostol is comfortable and easier to administer when compared to other routes and it has potential to be developed as a self-administered regimen. Buccal Misoprostol is as efficacious as vaginal Misoprostol with significantly lesser side effects up to 7 weeks of period of gestation.

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Section: Discussionmentioning

confidence: 90%

Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

Khan¹,

Kant²,

Thukral³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…To create a more accessible medical-abortion service, British Pregnancy Advisory Service (BPAS) — a non-profit abortion provider with 60 clinics in England and Wales— introduced the option of simultaneous administration of mifepristone and misoprostol in 2015. Prior research shows that simultaneous dosing is effective for early medical abortion, although the rate of side effects may be higher, and the need for more than one dose of misoprostol to achieve a complete abortion may arise more frequently, than with a 24-hour interval between medications (8, 9, 10, 11, 12). To avoid a second clinic visit, however, women may still prefer simultaneous dosing where home-use of misoprostol is restricted, despite potential differences between regimens.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Compared With Interval Medical Abortion Regimens Where Home Use Is Restricted

Lohr

Starling

Scott³

et al. 2018

Obstetrics &Amp; Gynecology

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Objective To evaluate outcomes with simultaneous administration of mifepristone and misoprostol for medical abortion at ≤63 days of gestation in the year after its implementation in a British clinic system. Methods We conducted a retrospective cohort study using de-identified data from the electronic booking and complications databases and medical records of women who underwent medical abortion at British Pregnancy Advisory Service. Our primary outcome was treatment success with simultaneous dosing versus a regimen with a 24–48 hour interval between medications. We defined success as complete abortion without surgical evacuation and without continuing pregnancy. To assess relative regimen effectiveness while accounting for self-assignment to simultaneous or interval dosing, we modeled the probability of treatment success using logistic regression with propensity-score adjustment for demographic and clinical characteristics. Secondary outcomes were reasons for abortion failure and clinically significant adverse events (hospital admission, blood transfusion, intravenous antibiotic administration). Results Of 28,901 women treated between May 2015 and April 2016, 85% chose simultaneous dosing. Overall success rates were high with both regimens but lower with simultaneous than with interval dosing (94.5% vs. 97.1% respectively, adjusted RR 0.973, 95% CI 0.967–0.979). For both regimens, success rates were lower at higher gestational ages, but the relative effectiveness of simultaneous dosing did not vary significantly with gestational age (p=0.268). Surgical intervention rates for continuing pregnancy were lowest at ≤49 days of gestation (1.4% simultaneous vs. 0.2% interval, p<0.001) and highest at 57–63 days (5.0% and 2.2%, p<0.001). The rate of clinically significant adverse events was 0.2% and did not differ by regimen (p=0.972). Conclusion Simultaneous administration of mifepristone and misoprostol is 97% as effective as a 24–48 hour interval at all gestational ages ≤63 days, with no increase in the risk of clinically significant adverse events. Pragmatic use of simultaneous dosing is reasonable given the small difference in effectiveness.

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“…[7][8][9][10][11][12] Overall it has been shown that an interval of approximately 6 hours between mifepristone and misoprostol results in equal efficacy as 24-48 hours in first-trimester abortion. There have been several studies specifically assessing the interval between mifepristone and misoprostol administration with respect to abortion outcome.…”

Section: Methods Of Study Selectionmentioning

confidence: 99%

Mifepristone–Misoprostol Dosing Interval and Effect on Induction Abortion Times

Shaw

Topp

Shaw

et al. 2013

Obstetrics &Amp; Gynecology

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Simultaneous use of mifepristone and misoprostol for early pregnancy termination

Abstract: Concurrent administration of oral mifepristone 200mg and vaginal misoprostol 600μg is an efficacious regimen for medical abortion of pregnancies up to 49 days of gestation.

Cited by 21 publications

References 14 publications

Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

Simultaneous Compared With Interval Medical Abortion Regimens Where Home Use Is Restricted

Mifepristone–Misoprostol Dosing Interval and Effect on Induction Abortion Times

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