Mifepristone: new preparation. Avoids or facilitates cervical dilatation before vacuum aspiration of pregnancy.
(1) Cervical softening with prostaglandins or laminaria before vacuum aspiration of pregnancy can avoid or facilitate mechanical dilatation. (2) Mifepristone is now licensed in France for cervical softening before vacuum aspiration of pregnancy. (3) The clinical file on mifepristone in this indication contains data from about 20 comparative clinical trials using surrogate end points, namely the need for and/or ease of cervical dilatation. (4) In these trials the cervix was easier to dilate in women who received mifepristone than in women who received a placebo. (5) A few comparative trials showed comparable efficacy of prostaglandins, laminaria (small hydrophilic stents inserted into the cervix that gradually swell, leading to cervical dilatation) and mifepristone in this indication. (6) Before vacuum aspiration, metrorrhagia occurred more frequently in women on mifepristone than in those on a placebo. Blood losses during vacuum aspiration were comparable in women who had received prostaglandins and those who had received mifepristone. (7) The incidence of abdominal pain may be lower on mifepristone than with laminaria or prostaglandins.
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use; D000028:Abortion, Induced / Q000379:methods; D020070:Cervical Ripening / Q000187:drug effects*; D002584:Cervix Uteri / Q000187:drug effects*; D002986:Clinical Trials as Topic; D004106:Dilatation / Q000379:methods; D005260:Female; D005602:France; D006727:Hormone Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007795:Laminaria; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011453:Prostaglandins / Q000627:therapeutic use
D000020:Abortifacient Agents, Nonsteroidal; D006727:Hormone Antagonists; D011453:Prostaglandins; D016595:Misoprostol; D015735:Mifepristone