Document Detail


A randomized trial comparing oral misoprostol with intra-amniotic prostaglandin F2alpha for second trimester terminations.
MedLine Citation:
PMID:  16529667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy of oral misoprostol with that of intra-amniotic prostaglandin F2alpha (PGF2alpha) for second trimester pregnancy termination. METHODS: One hundred seventeen women with pregnancies of between 16 and 22 weeks' gestation were randomly assigned after insertion of laminaria to receive either oral misoprostol 400 microg every 4 hours (to a maximum of four doses) or intra-amniotic PGF2alpha 40 mg. The rate of complete abortion within 24 hours was the primary outcome for power analysis. Secondary outcome measures were the rate of dilatation and curettage (D&C) for retained placenta and the rates of fever and gastrointestinal complications. RESULTS: Patient characteristics were similar in both groups. The rate of complete abortion within 24 hours was similar in the misoprostol (63%) and PGF2alpha (66%) groups. The rate of retained placenta requiring D&C was significantly greater in the PGF2alpha group (22.4% vs. 3.4%, P = 0.002). There were no differences in other maternal morbidities. Parous patients treated with oral misoprostol had a significantly greater rate of complete abortion than nulliparous patients (84% vs. 57%, P = 0.04). CONCLUSIONS: Oral misoprostol is as effective as intra-amniotic PGF2alpha for second trimester pregnancy termination when laminaria is inserted before treatment. Parous patients have a higher success rate than nulliparous patients with use of oral misoprostol. Oral misoprostol is associated with a very low rate of placental retention.
Authors:
Gerald P Marquette; M Amanda Skoll; Lorraine Dontigny
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC     Volume:  27     ISSN:  1701-2163     ISO Abbreviation:  J Obstet Gynaecol Can     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-03-13     Completed Date:  2006-05-09     Revised Date:  2007-06-29    
Medline Journal Info:
Nlm Unique ID:  101126664     Medline TA:  J Obstet Gynaecol Can     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1013-8     Citation Subset:  IM    
Affiliation:
University of British Columbia, British Columbia Women's Hospital and Health Centre, Vancouver, BC.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / standards*
Abortion, Induced*
Administration, Oral
Adult
Amniotic Fluid
Dinoprost / standards*
Female
Humans
Laminaria
Misoprostol / standards*
Parity
Placenta, Retained / epidemiology
Pregnancy
Pregnancy Trimester, Second
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 551-11-1/Dinoprost; 59122-46-2/Misoprostol
Comments/Corrections
Comment In:
J Obstet Gynaecol Can. 2006 Mar;28(3):189; author reply 190   [PMID:  16650352 ]

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


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