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Induction of abortion in early pregnancy with mifepristone in conjunction with gemeprost.

Abstract：

:This study was performed to investigate the efficacy of oral mifepristone and vaginal gemeprost for termination of early pregnancy. Eighty women requesting first trimester abortion and with amenorrhea of less than 56 days were included. Gestational age was confirmed with ultrasonography. Mifepristone was administered as a single 600 mg dose followed after 48 hours by a vaginal pessary containing 1 mg gemeprost. One woman did not return for gemeprost and later had a vacuum aspiration performed. There was complete abortion in all remaining women. No serious side effects were registered and the number of women requiring opioid analgesia was low (8%). The conclusion is that this treatment is a genuine alternative to vacuum aspiration but medical supervision is necessary for some time after gemeprost administration. :Physicians at Huddinge University Hospital in Stockholm, Sweden, administered a 600 mg dose of mifepristone (RU-486) then a vaginal pessary of 1 mg gemeprost ( a prostaglandin analogue) 48 hours later to 80 healthy 18-46 year old women requesting 1st trimester abortion (gestational age = 56 days). The physicians wanted to determine the side effects and efficacy of the RU-486/gemeprost regimen to induce abortion. 1 woman did not return for the vaginal pessary and later underwent vacuum aspiration. Just 1 woman experienced a complete abortion before gemeprost treatment. The remaining 78 women experienced complete abortion after gemeprost treatment. Uterine bleeding began immediately for 26 women and on days 1 an 2 for the remaining 52 women. It lasted from 3 to 17 days. Even though most women suffered some pain after gemeprost treatment, just 6 women (8%) needed to take an opioid analgesic. The mean hemoglobin level fell significantly on day 7 (from 127 to 123 g/l; p .01), but essentially returned to preabortion levels by day 14. None of the women needed a blood transfusion. Blood loss was comparable to that of vacuum aspiration. None of the women experienced severe side effects. These findings indicated that termination of early pregnancy with RU-486 and gemeprost is an acceptable option to vacuum aspiration. This regimen should be administered under close medical supervision just in case women need analgesia and to detect the few treatment failures.

journal_name

Acta Obstet Gynecol Scand

journal_title

Acta obstetricia et gynecologica Scandinavica

authors

Somell C,Olund A

doi

10.3109/00016349309013347

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

39-42

issue

eissn

0001-6349

issn

1600-0412

journal_volume

pub_type

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Induction of abortion in early pregnancy with mifepristone in conjunction with gemeprost.