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.
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References
Takahama K, Hoshiai H, Yajima A. Words and definition of early abortion [in Japanese]. Nihon Funin Gakkai Zasshi 1989;34(2): 297–301.
Christin-Maitre S, Bouchard P, Spitz IM. Medical termination of pregnancy. N Engl J Med. 2000;342(13):946–956.
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.
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.
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.
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.
Creinin MD, Pymar HC, Schwartz JL. Mifepristone 100 mg in abortion regimens. Obstet Gynecol. 2001;98(3):434–439.
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.
Heikinheimo O, Leminen R, Suhonen S. Termination of early pregnancy using flexible, low-dose mifepristone-misoprostol regimens. Contraception. 2007;76(6):456–460.
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.
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.
Xiao B, von Hertzen H, Zhao H, Piaggio G. Menstrual induction with mifepristone and misoprostol. Contraception. 2003;68(6): 489–494.
Bygdeman M. The possibility of using mifepristone for menstrual induction. Contraception. 2003;68(6):495–498.
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.
Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ 2000. 320(7239):916–919.
Shannon C, Brothers LP, Philip NM, Winikoff B. Ectopic pregnancy and medical abortion. Obstet Gynecol. 2004;104(1): 161–167.
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.
Farquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485): 583–591.
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.
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.
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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
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DOI: https://doi.org/10.1177/1933719114557897