Termination of 2nd and 3rd trimester pregnancies with mifepristone and misoprostol

Eur J Obstet Gynecol Reprod Biol. 1996 Dec 27;70(2):159-63. doi: 10.1016/s0301-2115(95)02593-6.

Abstract

Objective: The purpose of this study was to evaluate our use of the association of mifepristone and misoprostol for terminating second and third trimester pregnancies.

Study design: One hundred and six patients undergoing termination of pregnancy between January 1993 and June 1995 in our center were studied. Each patient received 600 mg of mifepristone followed 24 h later by 400 microgrammes of misoprostol every 6 h.

Results: The average interval from the first administration of misoprostol to expulsion was 12.5 +/- 7.5 h (interval markedly decreased to 9.6 +/- 6.3 h in cases of intrauterine fetal death).

Conclusion: The efficacy of the association of mifepristone and misoprostol is comparable with that of current regimens with grealer ease of utilization and at a much lower cost.

PIP: A clinical study of 106 second- and third-trimester induced abortions conducted at a hospital in Paris, France, confirmed the feasibility of a combined mifepristone-misoprostol regimen. All women were hospitalized and administered 600 mg of mifepristone, followed 24 hours later by 400 mcg of misoprostol every 6 hours until fetal expulsion. Medical reasons for pregnancy termination included fetal morphological abnormalities (34.9%), intrauterine death (26.4%), chromosome anomalies (16.9%), and maternal indications (19%). The average gestational age was 22.1 weeks (range, 15-41 weeks). The average expulsion interval was 12.5 +or- 7.5 hours (range, 30 minutes-38 hours). This interval was significantly shorter in multiparas, second-trimester pregnancies, and cases of fetal death. Mild side effects (e.g., vomiting, hyperthermia, and diarrhea) were noted in 34 patients (32%); there were no major complications. The mean length of hospital stay was 4.1 +or- 2.5 days. The efficacy of this regimen is comparable to that of regimens involving other abortifacient agents, but with the added advantages of greater ease of utilization and lower costs.

MeSH terms

  • Abortifacient Agents, Nonsteroidal*
  • Abortifacient Agents, Steroidal*
  • Abortion, Induced*
  • Adult
  • Female
  • Humans
  • Mifepristone* / administration & dosage
  • Mifepristone* / adverse effects
  • Misoprostol* / administration & dosage
  • Misoprostol* / adverse effects
  • Parity
  • Pregnancy
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Time Factors

Substances

  • Abortifacient Agents, Nonsteroidal
  • Abortifacient Agents, Steroidal
  • Misoprostol
  • Mifepristone