[Clinical study of terminating biochemical pregnancy and early clinical pregnancy with mifepristone and misoprostol].
キーワード
概要
OBJECTIVE
To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol.
METHODS
Mifepristone (150 mg) combined with misoprostol (600 microg) 3 days later were given to 500 biochemical pregnancies (G(1)), 500 early clinical pregnancies (G(2)) and 500 clinical pregnancies (G(3)) which were classified according to amenorrhea days, serum human chorionic gonadotropin-beta subunit (beta-hCG) and vaginal B-ultrasonic examinations. All were observed for 6 hours after taking misoprostol and returned for assessment per week.
RESULTS
Expulsion of conceptus was G(1) 123 (24.6%, 123/500), G(2) 438 (87.6%, 438/500) and G(3) 467 (93.4%, 467/500). Failure rate was G(1) 6 (1.2%, 6/500), G(2) 24 (4.8%, 24/500) and G(3) 79 (15.8%, 79/500) for ongoing pregnancies, hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding. Bleeding cases during the administration of mifepristone were G(1) 272 (54.4%, 272/500), G(2) 141 (28.2%, 141/500) and G(3) 87 (17.4%, 87/500); the mean bleeding days were G(1) (5.8 +/- 1.5), G(2) (9.0 +/- 2.9) and G(3) (14.3 +/- 5.9) days. Other side effects including abdominal pain, nausea, vomiting and diarrhea were low and light in each group, increasing with advancing gestational age. Menses recovery was 486 (97.2%, 486/500), 452 (90.4%, 452/500) and 433 (86.6%, 433/500) for each group on scheduled time. Satisfaction was 499 (99.8%, 499/500), 485 (97.0%, 485/500) and 369 (73.8%, 369/500) respectively.
CONCLUSIONS
Mifepristone and misoprostol in combination is as safe, and effective for termination of biochemical pregnancies as ordinary medical abortion. It does not need to wait till ectopic pregnancy is excluded.