Success of medication abortion with mifepristone followed by two doses of misoprostol in very early pregnancy

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY Contraception Pub Date : 2025-02-01 DOI:10.1016/j.contraception.2024.110696

Lindsay Burton , Rachel Perry , Janet Jacobson

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Abstract

Objectives

To compare medication abortion (MAB) success in very early pregnancy (VEP) with mifepristone followed by either one or two doses of misoprostol.

Study design

We performed a retrospective cohort analysis of VEP MABs from July 1, 2021 to May 31, 2022 treated with mifepristone 200 mg oral followed by a single dose of misoprostol 800 mcg buccal 24 to 48 hours later and MABs from June 21, 2022 to October 31, 2022 treated with mifepristone 200 mg oral followed by two doses of misoprostol 800 mcg buccal spaced 4 hours apart, with first dose taken 24 to 48 hours after mifepristone. Serum BhCG was collected at the time of mifepristone treatment with additional BhCG collected 48 to 72 hours after misoprostol treatment in both groups. Success was defined as a BhCG decline of ≥50%. MAB failure was defined as ongoing, viable pregnancy determined by follow-up ultrasound or procedural intervention with aspiration.

Results

There were 423 patients in the single-dose misoprostol group and 262 patients in the two-dose misoprostol group. There were no significant differences between the two groups in baseline characteristics. In the single-dose group, 372 (87.9%) were treated successfully; in the two-dose group, 224 (85.5%) were treated successfully. There was no significant difference in MAB success between the groups (p = 0.73).

Conclusions

The addition of a second dose of misoprostol does not improve the success of MAB in VEP.

Implications

Additional research is needed to identify interventions to improve the success of MAB in VEP.

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在早孕期使用米非司酮后再使用两剂米索前列醇进行药物流产的成功案例。

目的：比较药物流产（MAB）在极早期妊娠（VEP）中的成功率：比较使用米非司酮后再使用一剂或两剂米索前列醇的药物流产（MAB）在极早期妊娠（VEP）中的成功率：研究设计：我们对 2021 年 1 月 7 日至 2022 年 5 月 31 日期间使用米非司酮 200 毫克口服并在 24-48 小时后使用单剂量米索前列醇 800 毫微克口服液的 VEP 药物流产病例和 2022 年 6 月 21 日至 2022 年 10 月 31 日期间使用米非司酮 200 毫克口服并在 4 小时内间隔使用两剂量米索前列醇 800 毫微克口服液的药物流产病例进行了回顾性队列分析，第一剂在米非司酮使用 24-48 小时后服用。在米非司酮治疗时采集血清 BhCG，在米索前列醇治疗后 48-72 小时再采集血清 BhCG。成功的定义是 BhCG 下降大于或等于 50%。米索前列醇治疗失败的定义是通过随访超声波检查或吸宫术进行程序性干预而确定的持续存活妊娠：单剂量米索前列醇组共有 423 名患者，双剂量米索前列醇组共有 262 名患者。两组患者的基线特征无明显差异。单剂量组中，372 例（87.9%）患者治疗成功；双剂量组中，224 例（85.5%）患者治疗成功。两组的 MAB 成功率无明显差异（P=0.73）：临床试验注册号：临床试验注册号：不详。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.

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