The abortifacient effect of misoprostol in the second trimester. A randomized comparison with gemeprost in patients pre-treated with mifepristone (RU486).
The objective of this work was to study the abortifacient effects of misoprostol, an orally active prostaglandin E1 (PGE1) analogue, in the second trimester. A randomized study of two prostaglandin regimens in women pre-treated with the antiprogesterone mifepristone was carried out in the gynaecological wards of Aberdeen Royal Hospitals, NHS Trust, and included 60 women at 13-20 weeks' gestation, in whom termination of pregnancy had been agreed. Following pre-treatment with mifepristone 600 mg women were randomly allocated to one of two prostaglandin regimens which started 36-48 h later. The first misoprostol 400 micrograms orally (up to three doses) followed by gemeprost vaginal pessary 1 mg up to two doses. The second was gemeprost vaginal pessary 1 mg up to five doses. The main outcome measures were success rate induction-to-abortion interval and side-effects. There were no significant differences between the two groups in any of the main outcome measures. We conclude that misoprostol is a stable, cheap PGE1 analogue with demonstrable efficacy and acceptable side-effects in the management of second trimester abortion. Further work is needed to establish the optimum dose and regimen.
el-Refaey
H
H
Department of Obstetrics and Gynaecology, University of Aberdeen, Foresterhill, UK.
Hinshaw
K
K
Templeton
A
A
D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage / Q000494:pharmacology*; D016595:Misoprostol / Q000494:pharmacology*; D010570:Pessaries; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil