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Akkenapally PL. A Comparative Study of Misoprostol Only and Mifepristone Plus Misoprostol in Second Trimester Termination of Pregnancy. J Obstet Gynaecol India 2016; 66:251-7. [PMID: 27651613 DOI: 10.1007/s13224-016-0869-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 03/19/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14-20 weeks) . MATERIALS AND METHODS The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women. Group-I received only misoprostol; 600 mcg initial vaginal insertion followed by 400 mcg sublingually every 3 h until termination. Women in Group-II received mifepristone 200 mg and after 24 h started with 600 mcg misoprostol, per vaginal followed by 400 mcg sublingually till abortion was completed, up to a maximum of five doses in both groups. RESULTS The success rate in Group-I was 89 %, whereas in Group-II it was 96 %. The mean induction abortion interval in Group-I was 10.67 ± 3.96 h compared to Group-II which was significantly less 6.19 ± 2.70 h (p value < 0.01). The mean dose of misoprostol in Group-I was 1610 ± 511.18 mcg and in Group-II, it was lesser 1046 ± 392.71 mcg (p value < 0.01). There was significant difference in the mean blood loss also, 97.20 ± 36.35 ml in Group-I and 52.55 ± 27.96 ml in Group-II. Also among the individual groups multigravidae and lower gestational age (<17 weeks), women had lesser IAI as well as lesser misoprostol dose was required. CONCLUSION Pretreatment with mifepristone significantly reduces the induction abortion interval and the misoprostol dose along with minimal blood loss.
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Vaginal Misoprostol Compared With Buccal Misoprostol for Termination of Second-Trimester Pregnancy: A Randomized Controlled Trial. Obstet Gynecol 2015; 126:593-598. [PMID: 26181087 DOI: 10.1097/aog.0000000000000946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the efficacy of vaginal misoprostol with buccal misoprostol for second-trimester termination of pregnancies. METHODS In a randomized trial, we compared 400 micrograms vaginal and buccal misoprostol every 3 hours for up to six doses for induction of labor at 13-24 weeks of gestation with a live fetus and intact membranes. Women who had a uterine scar were excluded from the study. The primary outcome of the study was induction-to-abortion interval. Based on a two-tailed α of 0.05, we planned to include 65 patients per group to detect a 50% difference in the primary outcome with a power of 80%. RESULTS From January 2014 to December 2014, 172 women were screened and 130 were randomized: 65 vaginal and 65 buccal misoprostol. Characteristics of patients were similar between groups. Patients administered vaginal misoprostol compared with buccal misoprostol had a shorter induction-to-abortion interval (25±17 hours compared with 40±29 hours, P=.001) and a higher abortion rate within both 24 hours (41 [63%] compared with 27 [42%] P=.014) and 48 hours (59 [91%] compared with 44 [68%], P=.001). Complete abortion rates were similar in both groups (vaginal 51 [78%] compared with buccal 54 [83%]). The incidence of side effects was similar for both groups. The perceived pain was higher in the buccal group, but the small difference did not appear to be clinically meaningful. CONCLUSION Vaginal compared with buccal misoprostol administration has a shorter induction-to-abortion interval for second-trimester termination of viable pregnancies. However, both administration routes are equally effective for induction of termination. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, www.clinicaltrials.gov, NCT02048098. LEVEL OF EVIDENCE I.
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Chaudhuri P, Datta S. Mifepristone and misoprostol compared with misoprostol alone for induction of labor in intrauterine fetal death: A randomized trial. J Obstet Gynaecol Res 2015; 41:1884-90. [PMID: 26419824 DOI: 10.1111/jog.12815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Picklu Chaudhuri
- Department of Obstetrics and Gynecology; Nilratan Sircar Medical College, West Bengal University of Health Sciences; Kolkata India
| | - Sutapa Datta
- Department of Obstetrics and Gynecology; Nilratan Sircar Medical College, West Bengal University of Health Sciences; Kolkata India
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Dzuba IG, Grossman D, Schreiber CA. Off-label indications for mifepristone in gynecology and obstetrics. Contraception 2015; 92:203-5. [PMID: 26141817 DOI: 10.1016/j.contraception.2015.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Ilana G Dzuba
- Gynuity Health Projects, 15 E. 26th Street, Suite 801, New York, NY 10010.
| | - Daniel Grossman
- Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612; Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94110.
| | - Courtney A Schreiber
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 1000 Courtyard, Philadelphia, PA 19104.
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A double-blind randomized controlled trial of mifepristone or placebo before buccal misoprostol for abortion at 14-21 weeks of pregnancy. Int J Gynaecol Obstet 2015; 130:40-4. [PMID: 25896965 DOI: 10.1016/j.ijgo.2015.02.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 01/27/2015] [Accepted: 03/27/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess differences in outcomes of misoprostol with or without mifepristone for second-trimester abortion. METHODS A randomized, double-blind, placebo-controlled trial of buccal misoprostol following placebo or 200mg mifepristone was done in Tunisia among women presenting for abortions at 14-21 weeks of pregnancy between August 2009 and December 2011. Women with a live fetus, a closed cervical os, no cervical bleeding, and no contraindications to study drugs were eligible and underwent randomization (block size 10). Participants returned 24 hours later to receive 400 μg buccal misoprostol every 3 hours until complete fetal and placental expulsion (maximum 10 doses, five per 24-hour period). The primary outcomes were rates of complete uterine evacuation at 48 hours and time to expulsion. RESULTS A total of 120 women were evenly randomized to treatment. Complete uterine evacuation at 48 hours was recorded in 55 (91.7%) women in the combined group versus 43 (71.7%) in the misoprostol alone group (relative risk 1.28; 95% confidence interval 1.07-1.53). Mean time to complete abortion was 10.4±6.6 hours in the group who received mifepristone versus 20.6±9.7 hours in the misoprostol alone group (P<0.001). Side effects were similar in both groups. CONCLUSION Adding mifepristone before misoprostol can improve the quality of second-trimester abortion care by making the process faster.
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Patil E, Edelman A. Medical Abortion: Use of Mifepristone and Misoprostol in First and Second Trimesters of Pregnancy. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-014-0109-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jiang Q, Yang L, Ashley C, Medlin EE, Kushner DM, Zheng Y. Uterine rupture disguised by urinary retention following a second trimester induced abortion: a case report. BMC WOMENS HEALTH 2015; 15:1. [PMID: 25608736 PMCID: PMC4310148 DOI: 10.1186/s12905-014-0159-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022]
Abstract
Background Uterine rupture classically presents with severe abdominal pain, loss of fetal station, vaginal bleeding, and shock. Case presentation We present a case of uterine rupture presenting as significant urinary retention that occurred following a second trimester abortion induced with mifepristone and misoprostol. Uterine rupture was discovered unexpectedly on diagnostic laparoscopy. The uterine rupture was contained by dense adhesions between the omentum and bladder with the previous uterine cesarean hysterotomy scar. Conclusion This case highlights the difficulties in diagnosis of abnormal placentation and an unusual presentation of uterine rupture. This case was managed successfully laparoscopically.
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Affiliation(s)
- Qiaoying Jiang
- Department of Obstetrics and Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, People's Republic of China.
| | - Liwei Yang
- Department of Obstetrics and Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, People's Republic of China. .,Zhejiang Provincial People's Hospital, NO.158 Shangtang Road, Hangzhou, Zhejiang Province, 310014, China.
| | - Charles Ashley
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Erin E Medlin
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - David M Kushner
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Yanmei Zheng
- Department of Obstetrics and Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, People's Republic of China.
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Frye LJ, Winikoff B, Meckstroth K. Claims of misoprostol use based on blood sampling should be viewed with skepticism. Int J Gynaecol Obstet 2014; 127:125-6. [PMID: 25220862 DOI: 10.1016/j.ijgo.2014.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Efforts to prosecute women for induced abortion have included allegations that misoprostol was found in body fluids. These claims, however, are questionable owing to the timing of specimen collection for accurate results, the scarcity and expense of validated assays, and the onerous lab procedures required to determine the presence of the substance. Adequate scrutiny should be applied each time such a claim is made.
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Affiliation(s)
| | | | - Karen Meckstroth
- Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA
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Mifepristone and Oral, Vaginal, or Sublingual Misoprostol for Second-Trimester Abortion. Obstet Gynecol 2014; 123:1162-1168. [DOI: 10.1097/aog.0000000000000290] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hoopmann M, Hirneth J, Pauluschke-Fröhlich J, Yazdi B, Abele H, Wallwiener D, Kagan KO. Influence of Mifepristone in Induction Time for Terminations in the Second and Third Trimester. Geburtshilfe Frauenheilkd 2014; 74:350-354. [PMID: 25076791 DOI: 10.1055/s-0033-1360361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/19/2013] [Accepted: 01/14/2014] [Indexed: 10/25/2022] Open
Abstract
Termination of pregnancy after the first trimester is generally carried out by medical induction. Question: The aim of this study is to investigate the effect of mifepristone before administration of the prostaglandin derivative on induction time. Material and Methods: We analysed 333 medically indicated terminations after the first trimester under the terms of § 218 a Para. 2 of the German Criminal Code, in which the prostaglandin derivatives misoprostol, gemeprost or dinoprostone were administered with or without pre-treatment with 600 mg of mifepristone. The time interval between the initial administration of prostaglandin and delivery was investigated. Using uni- and multivariate regression analysis, the effect of maternal age, body mass index, gravidity and parity, previous Caesarean sections, gestational age and the induction regimen on the induction time were analysed. Results: The average induction time was significantly shortened with mifepristone (15.1 ± 11.9 hours with mifepristone vs. 25.3 ± 24.2 hours without mifepristone [p < 0.001]). The combination of mifepristone and misoprostol was most frequently used and proved to be the most effective regimen, reducing the induction period to 13.6 ± 10.3 hours. Besides pre-treatment with mifepristone, gestational age and a history of delivery without Caesarean section were significant influencing factors in reducing the induction time. Conclusion: The induction interval can be significantly shortened by the prior administration of mifepristone. The combination of mifepristone and misoprostol or gemeprost is the most effective regimen for the medical termination of pregnancy.
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Affiliation(s)
- M Hoopmann
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
| | - J Hirneth
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
| | | | - B Yazdi
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
| | - H Abele
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
| | - D Wallwiener
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
| | - K O Kagan
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen
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Bracken H, Ngoc NTN, Banks E, Blumenthal PD, Derman RJ, Patel A, Gold M, Winikoff B. Buccal misoprostol for treatment of fetal death at 14–28 weeks of pregnancy: a double-blind randomized controlled trial. Contraception 2014; 89:187-92. [DOI: 10.1016/j.contraception.2013.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 11/06/2013] [Accepted: 11/15/2013] [Indexed: 10/26/2022]
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Koski AD, Mirzabagi E, Cofie P, Tripathi V. Uterotonic Use at Childbirth in Ghana: A Qualitative Study of Practices, Perceptions, and Knowledge Among Facility-Based Health Care Providers and Community Members. INTERNATIONAL JOURNAL OF CHILDBIRTH 2014. [DOI: 10.1891/2156-5287.4.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE: Uterotonic drugs, administered immediately after delivery, can prevent postpartum hemorrhage (PPH). As programs expand uterotonic access in settings of high maternal mortality, it is important to understand why and how these drugs are currently used. This qualitative study aimed to describe Ghanaian health care providers’ and community members’ knowledge, perceptions, and practices of uterotonic usage at or near labor and delivery.METHODS: In-depth interviews were conducted in 3 districts with 185 physicians, medical assistants, midwives, nurses, new mothers, mothers aged 50 years and older, traditional birth attendants, and chemists.FINDINGS: Providers described using misoprostol most commonly for labor induction, oxytocin for labor augmentation and PPH prevention, and ergometrine for PPH treatment. Unsafe practices and knowledge gaps were identified regarding labor augmentation and uterotonic storage. Community members reported experience with uterotonics in facility deliveries. Community-based use of pharmaceutical uterotonics was rarely reported, except misoprostol for pregnancy termination; however, community members described use of herbal medicines for intended uterotonic effect. Across respondent categories, uterotonics were more commonly associated with accelerating delivery than PPH prevention.CONCLUSION: Programs promoting facility childbirth and/or uterotonic coverage at home births should consider these underlying patterns of use and encourage safe practices through provider and community engagement.
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Colleselli V, Schreiber CA, D'Costa E, Mangesius S, Wildt L, Seeber BE. Medical management of early pregnancy failure (EPF): a retrospective analysis of a combined protocol of mifepristone and misoprostol used in clinical practice. Arch Gynecol Obstet 2013; 289:1341-5. [PMID: 24305748 DOI: 10.1007/s00404-013-3105-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 11/18/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the efficacy of a combined protocol of mifepristone and misoprostol in the management of early pregnancy failure (EPF) and the average time to expulsion of tissue and rate of side effects. METHODS Retrospective chart review of all consecutive women treated with primary medical management for EPF at our institution from 2006 to 2012. RESULTS 168 patients were included in the present study. The overall success rate, defined as the absence of the need for surgical intervention, was 61 % and did not differ by calendar year. There was no difference in success rate grouped by diagnosis [intrauterine embryonic/fetal demise (IUED/IUFD) vs. anembryonic gestation; p = 0.30] or gestational age (<9 or ≥9 weeks; p = 0.48). The success rate varied significantly according to the required dose of misoprostol, ≤800 or >800 μg (68 vs. 50 %, p = 0.029). Of the possible predictive factors of success, only the dose of misoprostol required was a significant independent negative predictor. Mean and median time to tissue expulsion after the first dose of misoprostol were 8.4 and 5.5 h, respectively. The incidence of side effects was low with no blood transfusions required. CONCLUSIONS The success rate in this study is markedly below published data. This can possibly be attributed to retrospective study design, allowing for physician subjectivity and patients' wishes in the absence of strict study requirements. The protocol was well tolerated with a paucity of side effects. We make suggestions for enhancing success rates in the clinical setting by optimizing medication protocols, establishing precise treatment guidelines and training physicians in the accurate interpretation of treatment outcomes.
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Affiliation(s)
- Valeria Colleselli
- Department of Gynecologic Endocrinology and Reproductive Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
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Pongsatha S, Tongsong T. Randomized controlled trial comparing efficacy between a vaginal misoprostol loading and non-loading dose regimen for second-trimester pregnancy termination. J Obstet Gynaecol Res 2013; 40:155-60. [PMID: 24033985 DOI: 10.1111/jog.12147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to compare the efficacy of vaginal misoprostol loading dose regimen with non-loading dose regimen for termination of second-trimester pregnancy with live fetuses. MATERIAL AND METHODS A randomized controlled trial was conducted on pregnant women with a live fetus at 14-28 weeks. The patients were randomly allocated to receive either the vaginal misoprostol loading dose regimen (600 mcg, then 400 mcg every 6 h) or the non-loading dose regimen (400 mcg every 6 h). Failure to abort within 48 h was considered to be a failure. RESULTS Of 157 recruited women, 77 were assigned to be in group 1 (loading group) and 80 were in group 2 (non-loading group). The median abortion time was not statistically different between the groups (14.08; 95% confidence interval: 12.45-17.77 h and 14.58; 95% confidence interval: 12.8-17.27 h, P > 0.05). The rates of abortion within 24 h and 48 h were also comparable between the groups. Fever and chills were more common in the loading group. No other serious complications, such as postpartum hemorrhage and uterine rupture, were found. CONCLUSION Vaginal misoprostol in the loading dose regimen had a similar efficacy to the non-loading dose regimen but was associated with more adverse maternal effects.
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Affiliation(s)
- Saipin Pongsatha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Lee VCY, Gao J, Lee KF, Ng EHY, Yeung WSB, Ho PC. The effect of letrozole with misoprostol for medical termination of pregnancy on the expression of steroid receptors in the placenta. Hum Reprod 2013; 28:2912-9. [DOI: 10.1093/humrep/det345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mifepristone–Misoprostol Dosing Interval and Effect on Induction Abortion Times. Obstet Gynecol 2013; 121:1335-1347. [DOI: 10.1097/aog.0b013e3182932f37] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Borgatta L, Roncari D, Sonalkar S, Mark A, Hou MY, Finneseth M, Vragovic O. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception 2012; 86:567-71. [PMID: 22682721 DOI: 10.1016/j.contraception.2012.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 04/27/2012] [Accepted: 05/02/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cervical preparation is recommended before second-trimester abortion. We investigated the use of a pharmacologic method of preparation, mifepristone, as compared to osmotic dilators for surgical abortions at 14-16 weeks. STUDY DESIGN This was a randomized, parallel-group study with concealed allocation. Women were allocated to receive osmotic dilators or mifepristone 200 mg orally 24 h prior to abortion. The study population was 50 women seeking surgical abortion at 14-16 menstrual weeks in a hospital-based abortion service. The primary outcome was the length of time to perform the procedure; the study had 80% power to detect a difference of more than 3 min in procedure time. Secondary outcomes included cervical dilation, side effects and acceptability. RESULTS The mean abortion time for the osmotic dilator group was 8.00 min [95% confidence interval (CI) 6.75-11.47], and that for the mifepristone group was 9.87 min (95% CI 8.93-11.36). Side effects of pain were more common in the osmotic dilator group. CONCLUSION Mifepristone did not increase the time for abortion by more than the prespecified margin (3 min). Women preferred mifepristone to osmotic dilators.
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Affiliation(s)
- Lynn Borgatta
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA 021128, USA.
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Ji N, Zhou Y, Zhang Y, He D, Pang C, Xi M, Cheng Y. Medical abortion service in rural areas of Henan Province, China: a provider survey. J Obstet Gynaecol Res 2012; 39:672-9. [PMID: 23003112 DOI: 10.1111/j.1447-0756.2012.02004.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to explore the knowledge, attitudes and practices on medical abortion of abortion service providers in rural areas of China. MATERIAL AND METHODS A cross-sectional study via self-administered questionnaire was conducted among 362 abortion service providers from family planning service centers (FPSC) and hospitals in rural areas of Henan Province, China, between November 2009 and May 2010. RESULTS Most of the providers were female (99.4%) and obstetricians/gynecologists (63.3%). The knowledge score achieved ranged from 9.4 to 78.1 points, with both the median and the mode of 56.3 points. Of the 52.2% (189/362) of providers having a preference on abortion method, 30.2% (57/189) preferred medical abortion, while 69.8% (132/189) preferred surgical abortion. In total, 50.7% (174/343) of the providers indicated the provision of medical abortion should be expanded, with the three biggest challenges in its further expansion being increased complications/failures, poor client knowledge/awareness, and problems with drug/equipment supplies. Of all the providers, 81.7% and 92.2% reported they had experience in providing medical abortion and surgical abortion, respectively. Medical abortion providers were mainly experienced in misoprostol with oral (81.8%)/vaginal (79.6%) prostaglandin (misoprostol/gemeprost). CONCLUSION Knowledge on medical abortion of providers working in rural China was at a moderate level. Providers preferred surgical abortion to medical abortion. Providers have more experience in providing surgical abortion than medical abortion. Efforts should be made to overcome the perceived challenges in future expansion of medical abortion.
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Affiliation(s)
- Ning Ji
- Graduate School of Peking Union Medical College, Beijing, China
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