title: Short versus Standard Mifepristone and Misoprostol Regimen for Second- and Third-Trimester Termination of Pregnancy for Fetal Anomaly.
abstract: BACKGROUND
  Termination of pregnancy requires a 48-hour 'window' between mifepristone and misoprostol. Shorter durations have been used in first-trimester termination, but there are few data available in later termination for fetal anomaly.
  
  
  METHODS
  We reviewed all terminations for fetal anomaly at ≥13 weeks from May 2013 to May 2014. Cases were managed using a short (≤12 h) or standard (≥36 h) mifepristone-to-misoprostol interval.
  
  
  RESULTS
  Two hundred and twenty women underwent a termination of pregnancy for fetal anomaly during the study period, of which 119 were included for analysis. Sixty-six (55%) women were managed according to the short regimen and 53 (45%) women with the standard regimen. The short regimen resulted in a shorter mifepristone-to-delivery interval but was less likely to result in delivery within 12 h of misoprostol. Delivery rates at 24 h were equivocal. There was no difference in blood loss, vaginal delivery rates, complications or bed nights. The short regimen did require more doses of misoprostol. Feticide or previous uterine scar had no effect on outcomes.
  
  
  CONCLUSIONS
  There was no significant difference in clinical outcome for women managed with a short (≤12 h) or a standard (≥36 h) regimen for medical termination of pregnancy for fetal anomaly, suggesting that either regimen could be offered.
authors.affiliation: Department of Women and Children's Health Research, University Department, Liverpool Women's Hospital, Liverpool, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Sharp
authors.forename: Kate
authors.initials: K
authors.lastname: Navaratnam
authors.forename: Patricia
authors.initials: P
authors.lastname: Abreu
authors.forename: Zarko
authors.initials: Z
authors.lastname: Alfirevic
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D005260:Female; D005315:Fetal Diseases; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone