Comparison of Mifepristone Followed by Misoprostol with Misoprostol Alone for Treatment of Early Pregnancy Failure: A Randomized Double-Blind Placebo-Controlled Trial

被引：25

作者：

Sinha P. ^{[1
]}

Suneja A. ^{[1
]}

Guleria K. ^{[1
]}

Aggarwal R. ^{[1
,2
]}

Vaid N.B. ^{[1
]}

机构：

[1] Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi

[2] KL-99, Kavi Nagar, Ghaziabad, Uttar Pradesh

来源：

The Journal of Obstetrics and Gynecology of India | 2018年 / 68卷 / 1期

关键词：

Early pregnancy failure; Mifepristone; Misoprostol;

D O I：

10.1007/s13224-017-0992-5

中图分类号：

学科分类号：

摘要：

Objective: To compare the efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in the management of early pregnancy failure (EPF). Study Design: A randomized double-blind placebo-controlled clinical trial. Methods: Ninety-two women with EPF ≤12 weeks were recruited and randomly allocated to receive either mifepristone 200 mg (n = 46) or placebo (n = 46). Forty-eight hours later, patients in both the groups were given 800 µg misoprostol per-vaginum. If no expulsion occurred within 4 h, repeat doses of 400 µg misoprostol were given orally at 3-hourly interval to a maximum of 2 doses in women ≤9 weeks by scan and 4 doses in women >9 weeks by scan. Results: Pre-treatment of misoprostol with mifepristone significantly increased the complete abortion rate (86.7 vs. 57.8%, p = 0.009) and, hence, reduced the need for surgical evacuation (13.3 vs. 42.2%, p = 0.002), induction to expulsion interval (4.74 ± 2.24 vs. 8.03 ± 2.77 h, p = 0.000), mean number of additional doses of misoprostol required (0.68 vs. 1.91, p = 0.000), and side effects. Conclusion: Use of mifepristone prior to misoprostol in EPF significantly improves the efficacy and reduces the side effects of misoprostol alone. © 2017, Federation of Obstetric & Gynecological Societies of India.

引用

页码：39 / 44

页数：5

共 9 条

[1]

Speroff L., Glass R.H., Kase N.G., Clinical gynecologic endocrinology and infertility, (2011)

[2]

Gariepy A.M., Chen B.A., Management of early pregnancy failure, Obstetric evidence based guidelines, pp. 261-265, (2012)

[3]

Stockheim D., Machtinger R., Wiser A., Et al., A randomized prospective study of misoprostol or mifepristone followed by misoprostol when needed for the treatment of women with early pregnancy failure, Fertil Steril, 86, pp. 956-960, (2006)

[4]

The American College of Obstetricians and Gynecologists practice bulletin no. 150. Early pregnancy loss, Obstet Gynecol, 125, 5, pp. 1258-1267, (2015)

[5]

NICE: Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage, 154, (2012)

[6]

Schreiber C.A., Creinin M.D., Reever M.F., Et al., Mifepristopne and misoprostol for the treatment of early pregnancy failure: a pilot clinical trial, Contraception, 74, 6, pp. 458-462, (2006)

[7]

Kollitz K.M., Meyn L.A., Lohr P.A., Et al., Mifepristone and misoprostol for early pregnancy failure: a cohort analysis, Am J Obstet Gynecol, 204, 5, pp. 386-e1-386-e6, (2011)

[8]

Colleselli V., Schreiber C.A., D'Costa E., Et al., Medical management of early pregnancy failure (EPF): a retrospective analysis of a combined protocol of mifepristone and misoprostol used in clinical practice, Arch Gynecol Obstet, 289, 6, pp. 1341-1345, (2014)

[9]

van den Berg J., van den Bent J.M., Snijders M.P., Et al., Sequential use of mifepristone and misoprostol in treatment of early pregnancy failure appears more effective than misoprostol alone: a retrospective study, Eur J Obstet Gynecol Reprod Biol, 183, pp. 16-19, (2014)

← 1 →