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The efficacy and tolerance of mifepristone and prostaglandin in first trimester termination of pregnancy
Author(s) -
Uk Multicentre Trial
Publication year - 1990
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1990.tb02516.x
Subject(s) - medicine , mifepristone , obstetrics , misoprostol , curettage , abortion , pregnancy , gynecology , gestation , vaginal bleeding , vomiting , surgery , genetics , biology
Objective— To investigate the use of oral mifepristone (RU 486) and vaginal gemeprost for the induction of legal first trimester abortion. Design— An uncontrolled multicentre observational study. Setting— 13 Hospital gynaecological units in Scotland and England. Subjects— 588 Pregnant women with up to nine weeks amenorrhoea having legal abortions. Interventions— Oral mifepristone 600 mg followed 48 h later by vaginal gemeprost 1 mg. Women stayed in the hospital for a minimum of 4 h on each occasion. Main outcome measures— Frequency of complete abortion and the need for subsequent surgical evacuation, analgcsia and blood transfusion. Results— There was complete abortion in 94% (95% C192–96%). None of the 46 women at <43 days gestation needed surgical evacuation. This was performed in 6.5% of the remainder but among these the rate did not increase with gestation. Five women (four from one centre) required both curettagc and blood transfusion. A fall in haemoglobin concentration of 2–4 g/dl occurred in only 1%. Narcotic analgesia was required after gemeprost by 37% of nullipara and 13% of multipara. Overall 26% had vomiting and 13% diarrhoea. Conclusion— The sequential use of oral mifepristone and vaginal gemeprost is effective in inducing abortion up to the 63rd day of pregnancy. Efficient management of pain and bleeding is easier if women are in a hospital for some hours after the gemeprost.