Mifepristone and vaginal misoprostol on the same day for abortion from 50 to 63 days' gestation

Michelle C. Fox, Mitchell D. Creinin, Bryna Harwood

Research output: Contribution to journalArticle

Abstract

In a previous study of 40 women up to 49 days' gestation, our research center demonstrated that mifepristone 200 mg followed on the same day by misoprostol 800 μg vaginally produced abortion at rates similar to standard regimens which administer the two drugs 24 or 48 h apart. We performed this study to evaluate the same regimen in women with pregnancies at 50 to 63 days' gestation. Forty women from 50 to 56 days' gestation (Group 1) and 40 women from 57 to 63 days' gestation (Group 2) inserted misoprostol vaginally 6 to 8 h after taking mifepristone. Participants were instructed to return 24 ± 1 h after using misoprostol for an evaluation that included transvaginal ultrasonography. Subjects who had not aborted received a second dose of misoprostol to administer 48 h after the mifepristone. All participants were to return 2 weeks later. Ultrasound examinations were performed in those who required a second dose of misoprostol to confirm the abortion was successful. At 24 h after receiving misoprostol, 37/40 (93%, 95% CI 80, 98%) and 36/40 (90%, 95% CI 76, 97%) women from Groups 1 and 2, respectively, had expelled the pregnancy. By follow-up 2 weeks after taking mifepristone, all 40 women in Group 1 (100%, 95% CI 91,100%) and 39/40 women in Group 2 (98%, 95% CI 87,100%) had complete abortions. One woman in the latter group who aborted within the first 24 h had an incomplete abortion treated by suction curettage. This pilot study suggests that mifepristone 200 mg, followed on the same day by misoprostol 800 μg vaginally, effects abortion in women 50 to 63 days' gestation at rates comparable to regimens using longer dosing intervals between medications. Though this regimen is promising, larger randomized trials comparing it to standard regimens are needed before widespread use.

Original languageEnglish (US)
Pages (from-to)225-229
Number of pages5
JournalContraception
Volume66
Issue number4
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

Fingerprint

Misoprostol
Mifepristone
Pregnancy
Vacuum Curettage
Incomplete Abortion
Induced Abortion
Ultrasonography

Keywords

  • Abortion
  • Medical abortion
  • Mifepristone
  • Misoprostol

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Mifepristone and vaginal misoprostol on the same day for abortion from 50 to 63 days' gestation. / Fox, Michelle C.; Creinin, Mitchell D.; Harwood, Bryna.

In: Contraception, Vol. 66, No. 4, 01.10.2002, p. 225-229.

Research output: Contribution to journalArticle

Fox, Michelle C. ; Creinin, Mitchell D. ; Harwood, Bryna. / Mifepristone and vaginal misoprostol on the same day for abortion from 50 to 63 days' gestation. In: Contraception. 2002 ; Vol. 66, No. 4. pp. 225-229.
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abstract = "In a previous study of 40 women up to 49 days' gestation, our research center demonstrated that mifepristone 200 mg followed on the same day by misoprostol 800 μg vaginally produced abortion at rates similar to standard regimens which administer the two drugs 24 or 48 h apart. We performed this study to evaluate the same regimen in women with pregnancies at 50 to 63 days' gestation. Forty women from 50 to 56 days' gestation (Group 1) and 40 women from 57 to 63 days' gestation (Group 2) inserted misoprostol vaginally 6 to 8 h after taking mifepristone. Participants were instructed to return 24 ± 1 h after using misoprostol for an evaluation that included transvaginal ultrasonography. Subjects who had not aborted received a second dose of misoprostol to administer 48 h after the mifepristone. All participants were to return 2 weeks later. Ultrasound examinations were performed in those who required a second dose of misoprostol to confirm the abortion was successful. At 24 h after receiving misoprostol, 37/40 (93{\%}, 95{\%} CI 80, 98{\%}) and 36/40 (90{\%}, 95{\%} CI 76, 97{\%}) women from Groups 1 and 2, respectively, had expelled the pregnancy. By follow-up 2 weeks after taking mifepristone, all 40 women in Group 1 (100{\%}, 95{\%} CI 91,100{\%}) and 39/40 women in Group 2 (98{\%}, 95{\%} CI 87,100{\%}) had complete abortions. One woman in the latter group who aborted within the first 24 h had an incomplete abortion treated by suction curettage. This pilot study suggests that mifepristone 200 mg, followed on the same day by misoprostol 800 μg vaginally, effects abortion in women 50 to 63 days' gestation at rates comparable to regimens using longer dosing intervals between medications. Though this regimen is promising, larger randomized trials comparing it to standard regimens are needed before widespread use.",
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