One- and two-day mifepristone–misoprostol intervals for second trimester termination of pregnancy between 13 and 16weeks of gestation

Hou, Shuping; Zhang, Lanrong; Chen, Qinfang; Fang, Aihua; Cheng, Linan

doi:10.1016/j.ijgo.2010.06.008

« Previous Next »International Journal of Gynecology & Obstetrics
Volume 111, Issue 2 , Pages 126-130, November 2010

One- and two-day mifepristone–misoprostol intervals for second trimester termination of pregnancy between 13 and 16weeks of gestation

Shuping Hou
- Department of Gynecology and Obstetrics, The Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Lanrong Zhang
- Pudong New Area People's Hospital, Shanghai, China
Qinfang Chen
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Aihua Fang
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Linan Cheng
- WHO Collaborating Center for Research in Human Reproduction, Shanghai Institute of Planned Parenthood Research, Shanghai, China
- Corresponding author. Center for Clinical Research and Training Shanghai Institute of Planning Parenthood Research, WHO Collaborating Center for Research in Human Reproduction, 2140 Xie Tu Road, Shanghai 200032, China. Tel.: +86 21 64438803; fax: +86 21 64046128.

Received 28 January 2010; received in revised form 1 June 2010; accepted 7 July 2010. published online 12 August 2010.

Abstract

Objective

To compare the efficacy of 1-day and 2-day mifepristone and misoprostol intervals for second trimester termination of pregnancy between 13 and 16weeks.

Methods

A prospective randomized cohort study of 100 women who underwent voluntary termination between 13 and 16weeks of gestation. Patients were randomly assigned to receive 200mg of oral mifepristone, followed 1day (group 1) or 2days (group 2) later by 600μg of vaginal misoprostol. All patients received 400μg of oral misoprostol every 6hours for a maximum of 2doses. Main outcome measure was successful abortion rate at 24hours after the start of misoprostol treatment. Secondary outcome measures were induction-to-abortion interval and frequency of adverse events.

Results

The 24-hour successful abortion rate was similar between groups 1 and 2 (47 [94%] vs 50 [100%]; P=0.241). The mean misoprostol-to-abortion interval was also similar (7.0±3.0 vs 6.8±4.3hours; P=0.744). Among the 86 patients for whom histological examination of the products of conception was performed, retained chorionic villi rates were higher in the 1-day regimen group compared with the 2-day regimen group (46.2% [18/39] vs 29.8% [14/47]; P<0.001).

Conclusion

A 2-day mifepristone–misoprostol interval resulted in fewer incomplete abortions than a 1-day interval for second trimester termination of pregnancy between 13 and 16weeks.

Keywords: Incomplete abortion, Mifepristone, Misoprostol, Regimen interval, Second trimester termination, Termination of pregnancy