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Effect of letrozole on the uterine Doppler flow indices during early pregnancy: a randomised trial.
MedLine Citation:
PMID:  22302719     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: We demonstrated a marked reduction of serum estradiol concentration and a higher efficacy of the sequential regimen of letrozole and misoprostol in the first trimester termination of pregnancy when compared with misoprostol only. The aim of this study is to evaluate the effect of letrozole on the Doppler flow indices of uterine vessels during early pregnancy. Methods: This was a randomised controlled trial. Thirty women requesting termination of pregnancy up to 63 days gestation were randomised into two groups: letrozole group receiving 10 mg letrozole daily for 3 days whereas control groups receiving placebo for 3 days. Serum estradiol, progesterone and human chorionic gonadotrophin concentrations were measured before the drug administration and then daily for 6 days. Ultrasound scanning for fetal viability, and measurement of the pulsatility and resistance indices (PI and RI) of uterine vessels were performed before the drug administration, and then on day 3 and day 7 after starting letrozole or placebo. Results: PI and RI of uterine vessels decreased significantly in the letrozole group only. Serum estradiol concentrations were significantly lower in the letrozole group than the control group from day 2 onwards. Serum progesterone and hCG concentrations were comparable for both groups throughout 7 days. There were significantly more women in the letrozole group with vaginal bleeding. Conclusion: We demonstrated that the use of letrozole in first trimester pregnancy suppressed serum estradiol level, but resulted in an increase in blood flow to the uterus. Further studies should be carried out to elucidate the mechanism of letrozole pretreatment in medical abortion. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Vivian Chi Yan Lee; Tracy Wing Yee Yeung; Oi Shan Tang; Ernest Hung Yu Ng; William Shu Biu Yeung; Pak Chung Ho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-3
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics & Gynecology The University of Hong Kong Hong Kong Special Administrative Region People's Republic of China. v200lee@hku.hk.
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