| 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 |
Related Documents
:
|
17018479 - Unexplained prelabor uterine rupture in a term primigravida. 10955439 - An in vivo comparative study of the pregnant and nonpregnant cervix using electrical im... 11076099 - Successful uterine steroid therapy in a case with a history of ten miscarriages. |
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 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| 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
Previous Document: Informing policy for the Australian context - Costs, outcomes and cost savings of prenatal carrier s...
Next Document: Intra-uterine bupivacaine and levobupivacaine.