TAILIEUCHUNG - Early termination of pregnancy with mifepristone (RU486) and the orally active prostaglandin misoprostol

 The combination of mifepristone (RU 486) and a prostaglandin analogue given either intramuscularly or intravaginally is effective in terminating early pregnancy, but the prostaglandin component of the regimen is cumbersome to administer and has side effects. We conducted two studies to determine the efficacy of 600 mg of mifepristone followed by a small dose of misoprostol, an orally active prostaglandin E1 analogue, for the same purpose. In the first study, 505 women who had had amenorrhea for less than 50 days received 400 micrograms of misoprostol 48 hours after receiving mifepristone, if the pregnancy was not terminated within that period. In the second study, 390 women initially received the same treatment, but if the pregnancy was not terminated within four hours after the administration of misoprostol, they were offered an additional 200-micrograms dose of misoprostol. | The New England Journal of Medicine Copyright 1993 by the Massachusetts Medical Society Volume 328 MAY 27 1993 Number 21 EARLY TERMINATION OF PREGNANCY WITH MIFEPRISTONE RU 486 AND THE ORALLY ACTIVE PROSTAGLANDIN MISOPROSTOL Rémi Peyron . Elisabeth Aubếny . VẾRONIQUE Targosz . Louise Silvestre . Maguy Renault Franqois Elkik . Philippe Leclerc . André Ulmann . . AND Etienne-Emile Baulieu . . Abstract Background and Methods. The combination of mifepristone RU 486 and a prostaglandin analogue given either intramuscularly or intravaginally is effective in terminating early pregnancy but the prostaglandin component of the regimen is cumbersome to administer and has side effects. We conducted two studies to determine the efficacy of 600 mg of mifepristone followed by a small dose of misoprostol an orally active prostaglandin E1 analogue for the same purpose. In the first study 505 women who had had amenorrhea for less than 50 days received 400 fjLg of misoprostol 48 hours after receiving mifepristone if the pregnancy was not terminated within that period. In the second study 390 women initially received the same treatment but if the pregnancy was not terminated within four hours after the administration of misoprostol they were offered an additional 200-pcg dose of misoprostol. Results. In study 1 the rate of success termination of pregnancy and complete expulsion of the conceptus was percent 95 percent confidence interval to percent similar to the success rate of approximately 95 percent for mifepristone followed by the intramuscular or intravaginal administration of prostaglandin. Abortion occurred in percent of the women within 48 hours after Mifepristone RU 486 is a potent antiprogestin but when it is administered alone in early pregnancy termination of the pregnancy is incomplete in 20 percent or more of This relative lack of efficacy may be due to an insufficient increase in the prostaglandin .

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