Document Detail


Factors related to successful misoprostol treatment for early pregnancy failure.
MedLine Citation:
PMID:  16582130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify potential predictors for treatment success in medical management with misoprostol for early pregnancy failure.
METHODS: We conducted a planned secondary analysis of data from a multicenter trial that compared medical and surgical management of early pregnancy failure. Medical management consisted of misoprostol 800 mug vaginally on study day 1, with a repeat dose if indicated on day 3. Women returned on days 3 and 15, and a telephone interview was conducted on day 30. Failure was defined as suction aspiration for any reason within 30 days. Demographic, historical, and outcome variables were included in univariable analyses of success. Multivariable analyses were conducted using clinical site, gestational age, and variables for which the univariable analysis resulted in a P < .1 to determine predictors of overall treatment success and first-dose success.
RESULTS: Of the 491 women who received misoprostol, 485 met the criteria for this secondary analysis. Lower abdominal pain or vaginal bleeding within the last 24 hours, Rh-negative blood type, and nulliparity were predictive of overall success. However, only vaginal bleeding within the last 24 hours and parity of 0 or 1 were predictive of first-dose success. Overall success exceeds 92% in women who have localized abdominal pain within the last 24 hours, Rh-negative blood type, or the combination of vaginal bleeding in the past 24 hours and nulliparity.
CONCLUSION: Misoprostol treatment for early pregnancy failure is highly successful in select women, primarily those with active bleeding and nulliparity. Clinicians and patients should be aware of these differences when considering misoprostol treatment.
LEVEL OF EVIDENCE: II-2.
Authors:
Mitchell D Creinin; Xiangke Huang; Carolyn Westhoff; Kurt Barnhart; Jerry M Gilles; Jun Zhang;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  107     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-03     Completed Date:  2006-05-02     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  901-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, and Magee-Womens Research Institute, Pittsburgh, Pennsylvania 15213-3180, USA. mcreinin@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / therapeutic use*
Abortion, Incomplete / diagnosis,  drug therapy*
Abortion, Induced
Administration, Oral
Adolescent
Adult
Confidence Intervals
Female
Gestational Age
Humans
Maternal Age
Misoprostol / therapeutic use*
Odds Ratio
Parity
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, First
Probability
Prospective Studies
Reference Values
Risk Assessment
Vacuum Curettage / methods
Grant Support
ID/Acronym/Agency:
M01 RR000056-435563/RR/NCRR NIH HHS; M01RR000056/RR/NCRR NIH HHS; N01-HD-1-3321/HD/NICHD NIH HHS; N01-HD-1-3322/HD/NICHD NIH HHS; N01-HD-1-3323/HD/NICHD NIH HHS; N01-HD-1-3324/HD/NICHD NIH HHS; N01-HD-1-3325/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59122-46-2/Misoprostol
Comments/Corrections

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