The efficacy of oral Mifepristone (RU 38,486) with a prostaglandin E1 analog vaginal pessary for the termination of early pregnancy: complications and patient acceptability.
Outpatient terminations were performed on 100 ultrasonographically confirmed pregnancies of less than or equal to 63 days with a single oral dose of RU 38,486 (600 mg) and a single vaginal pessary of 16,16-dimethyl-trans-delta 2-prostaglandin E1 (1 mg) 48 hours later. Abortion occurred in all patients; in 95 it was complete, in four it was incomplete, and one resulted in a missed abortion. In 88% the abortion occurred within 4 hours of prostaglandin treatment. A total of 25% of patients had nausea and 15% vomited after RU 38,486 treatment. After prostaglandin-treatment, 13% vomited, 10% had diarrhea, and 23% required administration of an opiate analgesic agent. No patient was transfused and there was no genital tract trauma; one case of suspected pelvic infection occurred. If the need for termination arose again, 88% would elect to use the method again, 9% would not. The combination of the antiprogestin RU 38,486 and a vaginal prostaglandin pessary appears to offer a safe, efficient, acceptable nonsurgical outpatient method of termination. Further studies on dosage and treatment protocols would be justified.
Hill
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NC
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, England.
Ferguson
J
J
MacKenzie
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IZ
D000019:Abortifacient Agents / Q000008:administration & dosage*; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods; D000284:Administration, Oral; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D010342:Patient Acceptance of Health Care; D010446:Peptide Fragments / Q000097:blood; D010570:Pessaries; D011247:Pregnancy; D011261:Pregnancy Trimester, First
D000019:Abortifacient Agents; D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil