Interruption of early pregnancy with mifepristone in combination with gemeprost.
BACKGROUND
Mifepristone in combination with prostaglandin has been used since 1988 for induction of early abortion. The aim of the present investigation was to assess the tolerance and efficacy of 600 mg. mifepristone orally followed by gemeprost 1 mg. vaginally either 24 hours (group one) or 48 hours (group two) later.


METHODS
Sixty-four healthy women applying for abortion within the first 8 weeks of pregnancy were randomly allocated to one of the two treatment groups. Intrauterine pregnancy and gestational age were verified by ultrasonography. Symptoms after administration of mifepristone and gemeprost were recorded, and the patients observed at the hospital for at least three hours after prostaglandin-insertion. Blood samples for blood group, hemoglobin, beta-chorion-gonadotrophin, aspartate-aminotransferase and creatinine were drawn.


RESULTS
Outcome was established by gynecological examination, the level of beta-hCG and ultrasonography, at visits one, two and if necessary three to four weeks later. Surgical curettage was performed in case of incomplete abortion, of which there were four in the 24-hour interval group and five in the 48-hour interval group with a success rate (complete abortion) of 55 out of 64 patients (86%).


CONCLUSIONS
There was no difference in efficacy or side effects whether the prostaglandin was administered 24 or 48 hours after mifepristone intake, which suggests that the treatment period can be reduced from the conventional 48 hours.
Sandstrøm
O
O
Department of Obstetrics and Gynaecology, Hillerød Hospital, Denmark.
Brooks
L
L
Schantz
A
A
Grinsted
J
J
Grinsted
L
L
Jacobsen
J D
JD
Nielsen
S P
SP
D015746:Abdominal Pain / Q000209:etiology; D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D000328:Adult; D000527:Alprostadil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D013997:Time Factors; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil