Mifepristone versus vaginally administered misoprostol for cervical priming before first-trimester termination of pregnancy

A randomized, controlled study

P W Ashok, G M M Flett, A Templeton

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

OBJECTIVE: This study was undertaken to compare the effectiveness of mifepristone orally administered at 24 or 48 hours before first-trimester vacuum aspiration abortion with that of vaginally administered misoprostol as a cervical priming agent.
STUDY DESIGN: In a randomized comparative trial 90 women who requested surgical termination of pregnancy were randomly assigned to receive 200 mg mifepristone orally 24 or 48 hours before the operation or 800 mug misoprostol vaginally 2 to 4 hours before the operation. The main outcome measures were baseline cervical dilatation, cumulative force required to dilate the cervix to 9 mm, and intraoperative blood loss.
RESULTS: The baseline cervical dilatation was significantly greater among women who received mifepristone 48 hours before the operation (P=.02). This group also required the least mechanical force to dilate the cervix (P=.06). There were no significant differences among the 3 groups in the intraoperative blood loss, in the operating time, or in patient acceptability. Side effects such as hot flushes and headaches were significantly higher among women who received mifepristone 24 or 48 hours before the operation than among those who received misoprostol (P=.01 and P=.002, respectively).
CONCLUSION: Mifepristone is an effective cervical priming agent when orally administered 48 hours before vacuum aspiration for termination of first-trimester pregnancy. Because of its cost and availability in comparison with misoprostol, however, selective use may have to be considered.

Original languageEnglish
Pages (from-to)998-1002
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume183
Issue number4
DOIs
Publication statusPublished - Oct 2000

Keywords

  • induced abortion
  • mifepristone
  • misoprostol
  • first trimester
  • curettage abortion
  • vacuum aspiration
  • double blind
  • dilatation
  • Gemeprost
  • RU-486

Cite this

@article{e1e6a57e301841639e4f9674042cd5e4,
title = "Mifepristone versus vaginally administered misoprostol for cervical priming before first-trimester termination of pregnancy: A randomized, controlled study",
abstract = "OBJECTIVE: This study was undertaken to compare the effectiveness of mifepristone orally administered at 24 or 48 hours before first-trimester vacuum aspiration abortion with that of vaginally administered misoprostol as a cervical priming agent. STUDY DESIGN: In a randomized comparative trial 90 women who requested surgical termination of pregnancy were randomly assigned to receive 200 mg mifepristone orally 24 or 48 hours before the operation or 800 mug misoprostol vaginally 2 to 4 hours before the operation. The main outcome measures were baseline cervical dilatation, cumulative force required to dilate the cervix to 9 mm, and intraoperative blood loss. RESULTS: The baseline cervical dilatation was significantly greater among women who received mifepristone 48 hours before the operation (P=.02). This group also required the least mechanical force to dilate the cervix (P=.06). There were no significant differences among the 3 groups in the intraoperative blood loss, in the operating time, or in patient acceptability. Side effects such as hot flushes and headaches were significantly higher among women who received mifepristone 24 or 48 hours before the operation than among those who received misoprostol (P=.01 and P=.002, respectively). CONCLUSION: Mifepristone is an effective cervical priming agent when orally administered 48 hours before vacuum aspiration for termination of first-trimester pregnancy. Because of its cost and availability in comparison with misoprostol, however, selective use may have to be considered.",
keywords = "induced abortion, mifepristone, misoprostol, first trimester, curettage abortion, vacuum aspiration, double blind, dilatation, Gemeprost, RU-486",
author = "Ashok, {P W} and Flett, {G M M} and A Templeton",
year = "2000",
month = "10",
doi = "10.1067/mob.2000.106767",
language = "English",
volume = "183",
pages = "998--1002",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby/Elsevier,",
number = "4",

}

TY - JOUR

T1 - Mifepristone versus vaginally administered misoprostol for cervical priming before first-trimester termination of pregnancy

T2 - A randomized, controlled study

AU - Ashok, P W

AU - Flett, G M M

AU - Templeton, A

PY - 2000/10

Y1 - 2000/10

N2 - OBJECTIVE: This study was undertaken to compare the effectiveness of mifepristone orally administered at 24 or 48 hours before first-trimester vacuum aspiration abortion with that of vaginally administered misoprostol as a cervical priming agent. STUDY DESIGN: In a randomized comparative trial 90 women who requested surgical termination of pregnancy were randomly assigned to receive 200 mg mifepristone orally 24 or 48 hours before the operation or 800 mug misoprostol vaginally 2 to 4 hours before the operation. The main outcome measures were baseline cervical dilatation, cumulative force required to dilate the cervix to 9 mm, and intraoperative blood loss. RESULTS: The baseline cervical dilatation was significantly greater among women who received mifepristone 48 hours before the operation (P=.02). This group also required the least mechanical force to dilate the cervix (P=.06). There were no significant differences among the 3 groups in the intraoperative blood loss, in the operating time, or in patient acceptability. Side effects such as hot flushes and headaches were significantly higher among women who received mifepristone 24 or 48 hours before the operation than among those who received misoprostol (P=.01 and P=.002, respectively). CONCLUSION: Mifepristone is an effective cervical priming agent when orally administered 48 hours before vacuum aspiration for termination of first-trimester pregnancy. Because of its cost and availability in comparison with misoprostol, however, selective use may have to be considered.

AB - OBJECTIVE: This study was undertaken to compare the effectiveness of mifepristone orally administered at 24 or 48 hours before first-trimester vacuum aspiration abortion with that of vaginally administered misoprostol as a cervical priming agent. STUDY DESIGN: In a randomized comparative trial 90 women who requested surgical termination of pregnancy were randomly assigned to receive 200 mg mifepristone orally 24 or 48 hours before the operation or 800 mug misoprostol vaginally 2 to 4 hours before the operation. The main outcome measures were baseline cervical dilatation, cumulative force required to dilate the cervix to 9 mm, and intraoperative blood loss. RESULTS: The baseline cervical dilatation was significantly greater among women who received mifepristone 48 hours before the operation (P=.02). This group also required the least mechanical force to dilate the cervix (P=.06). There were no significant differences among the 3 groups in the intraoperative blood loss, in the operating time, or in patient acceptability. Side effects such as hot flushes and headaches were significantly higher among women who received mifepristone 24 or 48 hours before the operation than among those who received misoprostol (P=.01 and P=.002, respectively). CONCLUSION: Mifepristone is an effective cervical priming agent when orally administered 48 hours before vacuum aspiration for termination of first-trimester pregnancy. Because of its cost and availability in comparison with misoprostol, however, selective use may have to be considered.

KW - induced abortion

KW - mifepristone

KW - misoprostol

KW - first trimester

KW - curettage abortion

KW - vacuum aspiration

KW - double blind

KW - dilatation

KW - Gemeprost

KW - RU-486

U2 - 10.1067/mob.2000.106767

DO - 10.1067/mob.2000.106767

M3 - Article

VL - 183

SP - 998

EP - 1002

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 4

ER -