Evidence for shortening the time interval of prostaglandin after mifepristone for medical abortion.
OBJECTIVE
The aim of this study was to compare regimens that shorten the interval between mifepristone and the prostaglandin misoprostol or gemeprost for medical abortion.


METHODS
The Cochrane Controlled Trials Register and MEDLINE were systematically searched for the words mifepristone and abortion. Only randomized controlled trials comparing different mifepristone regimens with either misoprostol or gemeprost were included. The outcome was a complete abortion not requiring surgical evacuation.


RESULTS
Five randomized trials were identified and all were published since 1999. Four were from the United States and three had enrollments of >1000. The route of administration of the prostaglandin was used vaginally, except in one study where misoprostol was divided in two doses 2 h apart. Four studies provided information about a 1-day interval and two trials provided information about an interval of 6-8 h evaluating mifepristone 200 mg and misoprostol 800 microg vaginally. There were no significant differences noted between the current 2-day interval compared with the 1-day interval. There was one study suggesting no difference with an interval of 6-8 h.


CONCLUSIONS
The interval between mifepristone and misoprostol 800 microg vaginally can be decreased from 48 to 6-8 h without loss of efficacy.
Schaff
Eric
E
Department of Family Medicine, University at Buffalo, New York, USA. eschaff@ppde.edu
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D005260:Female; D006801:Humans; D016239:MEDLINE; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage; D011247:Pregnancy; D011453:Prostaglandins / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D011453:Prostaglandins; D016595:Misoprostol; D015735:Mifepristone