Document Detail


Mifepristone and second trimester pregnancy termination for fetal abnormality in Western Australia: Worth the effort.
MedLine Citation:
PMID:  20218999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the impact on the process of second trimester medical termination for fetal abnormality following the introduction of adjunctive mifepristone in an Australian tertiary hospital. METHODS: All second trimester medical terminations for fetal abnormality between July 2006 and June 2009 were prospectively identified. Two temporal therapeutic cohorts were created: the first (1 July 2006 to 31 December 2007) using vaginal misoprostol alone and the second (1 January 2008 to 30 June 2009) using mifepristone priming prior to the administration of misoprostol. The primary outcome was to evaluate the impact of mifepristone priming upon the duration of pregnancy termination. RESULTS: During the study period, 388 women with prenatally recognised fetal anomalies between 14 and 24 weeks gestation underwent medical termination: 189 with misoprostol alone and 199 with mifepristone priming followed by misoprostol. There was no difference between the groups for maternal age, parity or prior caesarean delivery. The median abortion duration was 15.5 h (interquartile ranges (IQR) 11.2-22.7) in the misoprostol group and 8.6 h (IQR 5.6-13.8) in the mifepristone primed group (P < 0.001). In both the groups, nulliparity and advancing gestation were associated with a significant prolongation of the abortion interval. Duration of hospitalisation was significantly longer in the misoprostol alone group (31.5 h (27-48.9) vs 27.2 h (22-31.5), misoprostol vs mifepristone priming, respectively, P < 0.001). CONCLUSIONS: The introduction of mifepristone priming prior to second trimester medical termination with misoprostol has resulted in a significant reduction in the duration of the termination procedure and length of inpatient stay. These observed benefits of mifepristone provide objective support for the decision to permit use of this medication in Australia.
Authors:
Jan E Dickinson; Phoebe Brownell; Kaitlin McGinnis; Elizabeth A Nathan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  50     ISSN:  1479-828X     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-11     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  IM    
Affiliation:
The University of Western Australia, Australia. jan.dickinson@uwa.edu.au
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage
Abortifacient Agents, Steroidal / administration & dosage*
Abortion, Induced / methods*
Administration, Intravaginal
Administration, Oral
Adult
Congenital Abnormalities
Critical Pathways
Drug Therapy, Combination
Female
Humans
Kaplan-Meiers Estimate
Length of Stay
Mifepristone / administration & dosage*
Misoprostol / administration & dosage
Pregnancy
Pregnancy Trimester, Second*
Western Australia
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Abortifacient Agents, Steroidal; 59122-46-2/Misoprostol; 84371-65-3/Mifepristone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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