The efficacy and tolerance of mifepristone and prostaglandin in first trimester termination of pregnancy. UK Multicentre Trial.
OBJECTIVE
To investigate the use of oral mifepristone (RU 486) and vaginal gemeprost for the induction of legal first trimester abortion.


METHODS
An uncontrolled multicentre observational study.


METHODS
13 Hospital gynaecological units in Scotland and England.


METHODS
588 Pregnant women with up to nine weeks amenorrhoea having legal abortions.


METHODS
Oral mifepristone 600 mg followed 48 h later by vaginal gemeprost 1 mg. Women stayed in the hospital for a minimum of 4 h on each occasion.


METHODS
Frequency of complete abortion and the need for subsequent surgical evacuation, analgesia and blood transfusion.


RESULTS
There was complete abortion in 94% (95% CI 92-96%). None of the 46 women at less than 43 days gestation needed surgical evacuation. This was performed in 6.5% of the remainder but among these the rate did not increase with gestation. Five women (four from one centre) required both curettage and blood transfusion. A fall in haemoglobin concentration of 2-4 g/dl occurred in only 1%. Narcotic analgesia was required after gemeprost by 37% of nullipara and 13% of multipara. Overall 26% had vomiting and 13% diarrhoea.


CONCLUSIONS
The sequential use of oral mifepristone and vaginal gemeprost is effective in inducing abortion up to the 63rd day of pregnancy. Efficient management of pain and bleeding is easier if women are in a hospital for some hours after the gemeprost.
D000019:Abortifacient Agents / Q000008:administration & dosage*; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000029:Abortion, Legal / Q000379:methods*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004739:England; D005260:Female; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011459:Prostaglandins E, Synthetic / Q000008:administration & dosage*; D012606:Scotland
D000019:Abortifacient Agents; D000020:Abortifacient Agents, Nonsteroidal; D011459:Prostaglandins E, Synthetic; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil