title: [Efficacy and safety of mifepristone combined with misoprostol for termination of pregnancy between 8 and 16 weeks of gestation].
abstract: OBJECTIVE
  To assess the efficacy and safety of mifepristone combined with oral or vaginal misoprostol for termination of pregnancy between 8 and 16 weeks of gestation.
  
  
  METHODS
  This was a randomized, multi-center, open clinical trial. A total of 625 women at 8-16 weeks of gestation were randomized to receive 200 mg oral mifepristone followed by either oral misoprostol 400 µg every 3 hours or vaginal misoprostol 400 µg every 6 hours for a maximum of 4 doses 36-48 hours later. There were 417 women in oral group with 198 at 8-9 weeks and 219 at 10-16 weeks, while 208 women in vaginal group with 99 at 8-9 weeks and 109 at 10-16 weeks. The outcome measures were the success abortion rate, induction to abortion interval, the amount of bleeding, reoccurrence of menstruation and adverse events.
  
  
  RESULTS
  Abortion rate was significantly higher in vaginal group [98.1% (202/206)] than that in oral group [94.0% (390/415), P = 0.023]; concerning termination of pregnancy at 8-9 weeks and 10-16 weeks respectively, there were no significant differences between oral and vaginal groups (P = 0.156, P = 0.073). The induction to abortion interval was no significant difference in oral and vaginal group in different gestational weeks (P = 0.238, P = 0.273). The average induction to abortion interval was (4.1 ± 6.6) hours and (6.0 ± 4.5) hours respectively in terminating 8-9 weeks and 10-16 weeks of gestation. Concerning the amount of bleeding within 2 hours of placenta expulsion, there was significant difference between oral group [(63 ± 46) ml] and vaginal group [(55 ± 45) ml] in terminating 8-9 weeks of gestation (P = 0.047), while there was no significant difference between groups in terminating 10-16 weeks of gestation [oral group (76 ± 52) ml versus vaginal group (76 ± 61) ml, P = 0.507]. The reoccurrence of menstruation was about 37 days in both oral and vaginal groups. Two cases of incomplete abortion were serious adverse events (SAE) relating to treatment. The common adverse events (AE) of nausea and vomiting were significantly higher in oral group [57.2% (239/417), 36.3% (151/417)] than those in vaginal group [45.4% (94/208), 26.1% (54/208); P = 0.005, 0.011].
  
  
  CONCLUSIONS
  Oral or vaginal misoprostol combined with mifepristone, is effective and safe for termination of pregnancy between 8 and 16 weeks of gestation.
authors: Department of Family Planning, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
authors: Jinfeng
authors: J
authors: Qian
authors: Xiaoping
authors: X
authors: Jing
authors: Shuying
authors: S
authors: Wu
authors: Shurong
authors: S
authors: Zheng
authors: Yi
authors: Y
authors: Li
authors: Mulan
authors: M
authors: Ren
authors: Wen
authors: W
authors: Di
authors: Huan
authors: H
authors: Shen
authors: Baihua
authors: B
authors: Dong
authors: Qing
authors: Q
authors: Chang
authors: Huirong
authors: H
authors: Shi
authors: Chen
authors: C
authors: Yao
authors: Wei
authors: W
authors: Song
authors: Email: zirong1130@hotmail.com.
authors: Zirong
authors: Z
authors: Huang
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000028:Abortion, Induced; D000282:Administration, Intravaginal; D000284:Administration, Oral; D005260:Female; D005865:Gestational Age; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage / Q000009:adverse effects*; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D015735:Mifepristone