Document Detail

Misoprostol versus cervagem for the induction of labour to terminate pregnancy in the second and third trimester: a systematic review.
MedLine Citation:
PMID:  16466671     Owner:  NLM     Status:  MEDLINE    
AIMS: to compare the benefits and harms of misoprostol to induce labour in the second and third trimester of pregnancy with cervagem. METHODS: MEDLINE was searched using the terms abortion, induced; abortifacient agents; pregnancy, second trimester; pregnancy, third trimester; misoprostol; cervagem; and gemeprost to identify randomised controlled trials in which misoprostol was compared with cervagem, for induction of labour to terminate pregnancy in the second or third trimester. Outcomes included vaginal birth not achieved within 24h; induction to delivery interval; analgesia requirements; blood loss; blood transfusion; surgical evacuation of the uterus; maternal death or serious maternal morbidity; side effects. RESULTS: Six randomised trials were included. Five compared vaginal misoprostol with cervagem [el Refaey H, Hinshaw K, Templeton A. The abortifacient effect of misoprostol in the second trimester: a randomized comparison with gemeprost in patients pre-treated with mifepristone (RU486). Hum Reprod 1993;8(10):1744-6; Ho PC, Chan YF, Lau W. Misoprostol is as effective as gemeprost in termination of second trimester pregnancy when combined with mifepristone: a randomised comparative trial. Contraception 1996;53(5):281-3; Nuutila M, Toivonen J, Ylikorkala O, Halmesmaki E. A comparison between two doses of intravaginal misoprostol and gemeprost for induction of second trimester abortion. Obstetr Gynecol 1997;90(6):896-900; Wong KS, Ngai CS, Wong AY, Tang LC, Ho PC. Vaginal misoprostol compared with vaginal gemeprost in termination of pregnancy: a randomized controlled trial. Contraception 1998;58(4):207-10; Dickinson JE, Godfrey M, Evans SF. Efficacy of intravaginal misoprostol in second trimester termination of pregnancy: a randomized controlled trial. J Mater Fetal Med 1999;7(3):115-9], and one oral misoprostol with gemeprost [Bartley J, Baird DT. A randomised study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy. Br J Obstetr Gynaecol 2002;109(11):1290-4]. Vaginal misoprostol compared with cervagem was associated with reduced narcotic analgesia (3 studies, 169 women, RR 0.64 95% CI 0.49-0.84), and surgical evacuation of the uterus (5 studies, 319 women, RR 0.71 95% CI 0.53-0.95). No other statistically significant differences were observed for other outcomes with reported data. In the single trial comparing oral misoprostol with gemeprost, reported outcomes were similar. CONCLUSIONS: Vaginal misoprostol for the termination of second and third trimester of pregnancy appears as effective as cervagem, but information about maternal safety is limited.
Jodie M Dodd; Caroline A Crowther
Publication Detail:
Type:  Journal Article; Review     Date:  2006-02-07
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  125     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-28     Completed Date:  2006-08-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
Maternal Fetal Medicine Specialist, Department of Obstetrics & Gynaecology, The University of Adelaide, 72 King William Road, North Adelaide 5006, Australia.
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MeSH Terms
Abortifacient Agents, Nonsteroidal*
Abortion, Induced*
Administration, Intravaginal
Administration, Oral
Alprostadil / analogs & derivatives*
Labor, Induced / methods*
Pregnancy Trimester, Second*
Pregnancy Trimester, Third*
Randomized Controlled Trials as Topic
Treatment Outcome
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59122-46-2/Misoprostol; 64318-79-2/gemeprost; 745-65-3/Alprostadil

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