Skip to main content

Advertisement

Log in

Effectiveness and Safety of Lower Doses of Mifepristone Combined With Misoprostol for the Termination of Ultra-Early Pregnancy: A Dose-Ranging Randomized Controlled Trial

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

This study aimed to investigate the effectiveness and safety of lower doses of mifepristone combined with misoprostol for the termination of ultra-early pregnancy. A total of 2500 women with ultra-early pregnancy (amenorrhea ≤ 35 days) were randomly divided into 5 groups with gradually decreased dose of oral mifepristone from 150 to 50 mg followed by 200 µg of oral misoprostol 24 hours later. The primary end point was complete abortion without surgical intervention. Secondary end points were vaginal bleeding, return of menses, and side effects. Rates of complete abortion were high in all groups. Moreover, the lower doses of mifepristone led to shorter vaginal bleeding period, the return of menses on the expected date, and fewer side effects. Lower doses of mifepristone combined with 200 µg of misoprostol are as effective and safe as higher doses of this combination for the termination of ultra-early pregnancy with lower possibility of vaginal bleeding and side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Takahama K, Hoshiai H, Yajima A. Words and definition of early abortion [in Japanese]. Nihon Funin Gakkai Zasshi 1989;34(2): 297–301.

    CAS  PubMed  Google Scholar 

  2. Christin-Maitre S, Bouchard P, Spitz IM. Medical termination of pregnancy. N Engl J Med. 2000;342(13):946–956.

    Article  CAS  Google Scholar 

  3. Goldstone P, Michelson J, Williamson E. Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study. Med J Aust. 2012;197(5): 282–286.

    Article  Google Scholar 

  4. Kulier R, Kapp N, Gulmezoglu AM, Hofmeyr GJ, Cheng L, Campana A. Medical methods for first trimester abortion. Cochrane Database Syst Rev. 2011;11:CD002855.

    Google Scholar 

  5. Li CL, Wei M, Fu MF, Li M. Clinical study of terminating biochemical pregnancy and early clinical pregnancy with mifepristone and misoprostol [in Chinese]. Zhonghua Fu Chan Ke Za Zhi. 2007; 42(8):542–545.

    CAS  PubMed  Google Scholar 

  6. Jerbi M, Hidar S, Sahraoui W, et al. Mifepristone 100 mg for early medical abortion [in French]. J Gynecol Obstet Biol Reprod (Paris). 2005;34(3 pt 1):257–261.

    Article  CAS  Google Scholar 

  7. Creinin MD, Pymar HC, Schwartz JL. Mifepristone 100 mg in abortion regimens. Obstet Gynecol. 2001;98(3):434–439.

    CAS  PubMed  Google Scholar 

  8. Lowering the doses of mifepristone and gameprost for early abortion: a randomised controlled trial. World Health Organization Task Force on Post-ovulatory Methods for Fertility Regulation. BJOG. 2001;108(7):738–742.

    Google Scholar 

  9. Heikinheimo O, Leminen R, Suhonen S. Termination of early pregnancy using flexible, low-dose mifepristone-misoprostol regimens. Contraception. 2007;76(6):456–460.

    Article  CAS  Google Scholar 

  10. Li CL, Chen DJ, Sheng XJ, et al. The lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancy [in Chinese]. Zhonghua Fu Chan Ke Za Zhi. 2012;47(10):764–768.

    CAS  PubMed  Google Scholar 

  11. Rorbye C, Norgaard M, Nilas L. Prediction of late failure after medical abortion from serial beta-hCG measurements and ultrasonography. Hum Reprod. 2004;19(1):85–89.

    Article  CAS  Google Scholar 

  12. Xiao B, von Hertzen H, Zhao H, Piaggio G. Menstrual induction with mifepristone and misoprostol. Contraception. 2003;68(6): 489–494.

    Article  CAS  Google Scholar 

  13. Bygdeman M. The possibility of using mifepristone for menstrual induction. Contraception. 2003;68(6):495–498.

    Article  CAS  Google Scholar 

  14. Saraiya M, Berg CJ, Shulman H, Green CA, Atrash HK. Estimates of the annual number of clinically recognized pregnancies in the United States, 1981–1991. Am J Epidemiol. 1999; 149(11):1025–1029.

    Article  CAS  Google Scholar 

  15. Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ 2000. 320(7239):916–919.

    Article  CAS  Google Scholar 

  16. Shannon C, Brothers LP, Philip NM, Winikoff B. Ectopic pregnancy and medical abortion. Obstet Gynecol. 2004;104(1): 161–167.

    Article  Google Scholar 

  17. van Mello NM, Mol F, Ankum WM, Mol BW, van der Veen F, Hajenius PJ. Ectopic pregnancy: how the diagnostic and therapeutic management has changed. Fertil Steril. 2012;98(5): 1066–1073.

    Article  Google Scholar 

  18. Farquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485): 583–591.

    Article  Google Scholar 

  19. Kapp N, Borgatta L, Ellis SC, Stubblefield P. Simultaneous very low dose mifepristone and vaginal misoprostol for medical abortion. Contraception. 2006;73(5):525–527.

    Article  CAS  Google Scholar 

  20. von Hertzen H, Huong NT, Piaggio G, et al. Misoprostol dose and route after mifepristone for early medical abortion: a randomised controlled noninferiority trial. BJOG. 2010 117(10):1186–1196.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cui-Lan Li MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, CL., Chen, DJ., Song, LP. et al. Effectiveness and Safety of Lower Doses of Mifepristone Combined With Misoprostol for the Termination of Ultra-Early Pregnancy: A Dose-Ranging Randomized Controlled Trial. Reprod. Sci. 22, 706–711 (2015). https://doi.org/10.1177/1933719114557897

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719114557897

Keywords

Navigation