A prospective randomized study on the measured blood loss in medical termination of early pregnancy by three different misoprostol regimens after pretreatment with mifepristone.
BACKGROUND
Prolonged vaginal bleeding is a common complaint after medical abortion. The effect of a 1 week course of daily oral misoprostol after medical abortion with mifepristone and misoprostol on the amount of post-abortal blood loss was studied.


METHODS
A total of 150 women (gestation <or=63 days) were randomized to three groups using computer-generated tables. They received 200 mg oral mifepristone, followed 48 h later by 0.8 mg oral misoprostol and vaginal placebo in group A, and 0.8 mg vaginal misoprostol and oral placebo in groups B and C. In groups A and B, the women continued with oral misoprostol 0.4 mg twice daily on days 4-10, while the women in group C took placebo. The actual blood loss was measured by the alkaline haematin method.


RESULTS
No significant difference in the median amount (82.8, 94.7 and 88.5 ml for A, B and C respectively) and duration (16, 15 and 16 days respectively) of vaginal bleeding was observed. The incidence of diarrhoea was significantly higher (66, 55.1 and 12.5% respectively) in the groups with oral misoprostol after abortion.


CONCLUSIONS
A 1 week course of oral misoprostol (0.4 mg twice daily) could not decrease the duration and amount of vaginal bleeding. Further studies with a larger sample size are needed to assess whether the complete abortion rate can be improved with this regimen.
Tang
Oi Shan
OS
Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. ostang@graduate.hku.hk
Lee
Sharon W H
SW
Ho
Pak Chung
PC
D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D003967:Diarrhea / Q000139:chemically induced; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000009:adverse effects* / Q000627:therapeutic use*; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D017211:Treatment Failure; D014592:Uterine Hemorrhage / Q000139:chemically induced* / Q000188:drug therapy*
D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone