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Erschienen in: Archives of Gynecology and Obstetrics 4/2012

01.04.2012 | General Gynecology

Efficacy and safety of mifepristone and buccal misoprostol versus buccal misoprostol alone for medical abortion

verfasst von: Krishna Dahiya, Kamlesh Ahuja, Atul Dhingra, Nirmala Duhan, Smiti Nanda

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2012

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Abstract

Objectives

To evaluate the efficacy and safety of mifepristone and buccal misoprostol versus buccal misoprostol alone in medical abortion of ≤56 days.

Study design

One hundred pregnant women having gestational age ≤56 days were randomized to group A and group B. In group A, patients received 200 mg mifepristone on day 1, followed by buccal misoprostol 800 µg on day 2, and in group B patients received 800 µg buccal misoprostol only on day 1.

Main outcome measures

Complete abortion was the principal outcome measure. Secondary outcome measures were side-effects and acceptability.

Results

Forty-six (92%) patients in group A and 37 (74%) patients in group B aborted successfully (p value 0.017). Four (8%) patients in group A and eight (16%) patients in group B had incomplete abortion with retained products of conception. In group B, three (6%) patients had missed abortion and two (4%) patients had continued pregnancy whereas none of the patients in group A had missed abortion or continued pregnancy. The overall method acceptance was 100% whereas the overall route acceptance was 83%.

Conclusion

Misoprostol-alone regimen is a low-cost regimen as compared to mifepristone/misoprostol regimen. Though the efficacy of mifepristone followed by buccal misoprostol is better, buccal misoprostol alone can be used for termination of pregnancy in patients where mifepristone is either unavailable or contraindicated.
Literatur
1.
Zurück zum Zitat Clark W, Gold M, Grossman D, Winnikoff B (2007) Can mifepristone medical abortion be simplified? Contracept 75:245–250CrossRef Clark W, Gold M, Grossman D, Winnikoff B (2007) Can mifepristone medical abortion be simplified? Contracept 75:245–250CrossRef
2.
Zurück zum Zitat Middleton T, Schaff E, Fielding SL, Scahill M, Shannon C, Westheimer E et al (2005) Randomized trial of mifepristone and buccal or vaginal misoprostol for abortion through 56 days of last menstrual period. Contracept 72:328–332CrossRef Middleton T, Schaff E, Fielding SL, Scahill M, Shannon C, Westheimer E et al (2005) Randomized trial of mifepristone and buccal or vaginal misoprostol for abortion through 56 days of last menstrual period. Contracept 72:328–332CrossRef
3.
Zurück zum Zitat Castleman LD, Oanh KT, Hyman AG, Thuy Le T, Blumenthal BD (2006) Introduction of the dilatation and evacuation procedure for second trimester abortion in Vietnam using manual vacuum aspiration and buccal misoprostol. Contracept 74:272–276CrossRef Castleman LD, Oanh KT, Hyman AG, Thuy Le T, Blumenthal BD (2006) Introduction of the dilatation and evacuation procedure for second trimester abortion in Vietnam using manual vacuum aspiration and buccal misoprostol. Contracept 74:272–276CrossRef
4.
Zurück zum Zitat Carlan SJ, Blust D, O’Brien W (2002) Buccal versus intravaginal misoprostol administration for cervical ripening. Obstet Gynecol 186:229–233CrossRef Carlan SJ, Blust D, O’Brien W (2002) Buccal versus intravaginal misoprostol administration for cervical ripening. Obstet Gynecol 186:229–233CrossRef
5.
Zurück zum Zitat Elul B, Hajri S, Ngoc NN, Ellertson C, Slama CB, Pearlman E et al (2001) Can women in less developed countries use a simplified abortion regimen? Lancet 357:1402–1405PubMedCrossRef Elul B, Hajri S, Ngoc NN, Ellertson C, Slama CB, Pearlman E et al (2001) Can women in less developed countries use a simplified abortion regimen? Lancet 357:1402–1405PubMedCrossRef
6.
Zurück zum Zitat UK Multicentre Trial (1990) The efficacy, tolerance of mifepristone, prostaglandin in first trimester termination of pregnancy. Br J Obstet Gynecol 97:480–486CrossRef UK Multicentre Trial (1990) The efficacy, tolerance of mifepristone, prostaglandin in first trimester termination of pregnancy. Br J Obstet Gynecol 97:480–486CrossRef
7.
Zurück zum Zitat World Health Organization (1993) Termination of pregnancy with reduced doses of mifepristone. Br Med J 307:532–537CrossRef World Health Organization (1993) Termination of pregnancy with reduced doses of mifepristone. Br Med J 307:532–537CrossRef
8.
Zurück zum Zitat Baird DT, Sukcharoen N, Thong KJ (1995) Randomized trial of misoprostol and cervagem in combination with a reduced dose of mifepristone for induction of abortion. Hum Reprod 10:1521–1527PubMed Baird DT, Sukcharoen N, Thong KJ (1995) Randomized trial of misoprostol and cervagem in combination with a reduced dose of mifepristone for induction of abortion. Hum Reprod 10:1521–1527PubMed
9.
Zurück zum Zitat Heikinheimo O, Croxatto H, Salvatierra AM, Chang CC, Luukkainen T, Lahteemaki P (1987) Intravaginal administration of RU 486 in humans and rats: inadequate absorption in humans. Hum Reprod 2:645–648PubMed Heikinheimo O, Croxatto H, Salvatierra AM, Chang CC, Luukkainen T, Lahteemaki P (1987) Intravaginal administration of RU 486 in humans and rats: inadequate absorption in humans. Hum Reprod 2:645–648PubMed
10.
Zurück zum Zitat Brogden RN, Goa KL, Faylds D (1993) Mifepristone: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential. Drugs 45:384–409PubMedCrossRef Brogden RN, Goa KL, Faylds D (1993) Mifepristone: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential. Drugs 45:384–409PubMedCrossRef
11.
Zurück zum Zitat Heikinheimo O (1989) Pharmacokinetics of antiprogesterone (RU 486) in women during multiple doses administration. J Steroid Biochem 32(Suppl lA):21–25PubMedCrossRef Heikinheimo O (1989) Pharmacokinetics of antiprogesterone (RU 486) in women during multiple doses administration. J Steroid Biochem 32(Suppl lA):21–25PubMedCrossRef
12.
Zurück zum Zitat Winikoff B, Dzuba IG, Creinin MD, Mitchell DC, Crowden WA (2008) Two distinct oral routes of misoprostol in mifepristone medical abortion: a randomized controlled trial. Obstet Gynecol 112:1303–1310PubMedCrossRef Winikoff B, Dzuba IG, Creinin MD, Mitchell DC, Crowden WA (2008) Two distinct oral routes of misoprostol in mifepristone medical abortion: a randomized controlled trial. Obstet Gynecol 112:1303–1310PubMedCrossRef
13.
Zurück zum Zitat Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V (2009) Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days. Contracept 80(3):282–286CrossRef Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V (2009) Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days. Contracept 80(3):282–286CrossRef
14.
Zurück zum Zitat Bugalho A, Mocumbi S, Faúndes A, David E (2000) Termination of pregnancies of <6 weeks gestation with a single dose of 800 μg of vaginal misoprostol. Contracept 61:47–50CrossRef Bugalho A, Mocumbi S, Faúndes A, David E (2000) Termination of pregnancies of <6 weeks gestation with a single dose of 800 μg of vaginal misoprostol. Contracept 61:47–50CrossRef
15.
Zurück zum Zitat Jain JK, Dutton C, Harwood B, Meckstroth KR, Mishell DR Jr (2002) A prospective randomized, double blinded, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Hum Reprod 17(6):1477–1482PubMedCrossRef Jain JK, Dutton C, Harwood B, Meckstroth KR, Mishell DR Jr (2002) A prospective randomized, double blinded, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Hum Reprod 17(6):1477–1482PubMedCrossRef
16.
Zurück zum Zitat Lohr PA, Matthew FR, Jennifer LH, Bryna H, Mitchell DC (2007) Oral mifepristone and buccal misoprostol administered simultaneously for abortion: a pilot study. Contracept 76:215–220CrossRef Lohr PA, Matthew FR, Jennifer LH, Bryna H, Mitchell DC (2007) Oral mifepristone and buccal misoprostol administered simultaneously for abortion: a pilot study. Contracept 76:215–220CrossRef
Metadaten
Titel
Efficacy and safety of mifepristone and buccal misoprostol versus buccal misoprostol alone for medical abortion
verfasst von
Krishna Dahiya
Kamlesh Ahuja
Atul Dhingra
Nirmala Duhan
Smiti Nanda
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 4/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-2110-8

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