title: Menstrual induction with mifepristone and misoprostol.
abstract: Menstrual induction refers to early uterine evacuation without laboratory confirmation of pregnancy in women with delayed menses. Mechanical aspiration is the method used in many countries but, as suggested by a pilot study, mifepristone followed by a prostaglandin analogue could also be effective. We launched the present study to evaluate the efficacy and side effects of 150 mg of mifepristone, followed 2 days later by 0.4 mg misoprostol vaginally, for menstrual induction among women with a menstrual delay of up to 7 days. The outcome of treatment was uterine evacuation, which could mean menstruation or termination of early pregnancy. A total of 720 women were recruited. The mean delay of menstruation at recruitment was 4.9 (SD = 1.7) days. Retrospective analysis of human chorionic gonadotropin from serum samples taken at admission showed that 492 (68.3%) women were pregnant at admission, and 228 (31.7%) women had delayed menstruation without pregnancy. One nonpregnant woman was lost to follow-up. Bleeding was induced in 479 (97.4%) pregnant women and in 222 (97.8%) nonpregnant women. Among the pregnant women, 455 (92.5%) had complete abortion, 12 (2.4%) had incomplete abortion and pregnancy continued in 25 (5.1%) women, including one ectopic pregnancy. Side effects were mild and uncommon. We conclude that 95.8% of the women treated had the expected outcome. Further research is needed to compare the efficacy, safety and acceptability of the medical regimen to vacuum aspiration. A rather high continuing pregnancy rate in this study is a concern.
authors.affiliation: National Research Institute for Family Planning, No. 12 Da Hui Si, 100081, Beijing, People's Republic of China. xiaobl@public.bta.net.cn
authors.forename: Bilian
authors.initials: B
authors.lastname: Xiao
authors.forename: Helena
authors.initials: H
authors.lastname: von Hertzen
authors.forename: Heng
authors.initials: H
authors.lastname: Zhao
authors.forename: Gilda
authors.initials: G
authors.lastname: Piaggio
mesh_terms: D000328:Adult; D003276:Contraceptives, Oral / Q000009:adverse effects / Q000494:pharmacology; D003283:Contraceptives, Postcoital, Synthetic / Q000494:pharmacology*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008598:Menstruation / Q000187:drug effects*; D008600:Menstruation-Inducing Agents / Q000494:pharmacology; D015735:Mifepristone / Q000009:adverse effects / Q000494:pharmacology*; D016595:Misoprostol / Q000009:adverse effects / Q000494:pharmacology*; D012189:Retrospective Studies
chemical_list: D003276:Contraceptives, Oral; D003283:Contraceptives, Postcoital, Synthetic; D008600:Menstruation-Inducing Agents; D016595:Misoprostol; D015735:Mifepristone