Abstract
Objectives
Medical regimens using mifepristone in combination with prostaglandins have been widely
available for women undergoing termination of pregnancy (TOP) at 10–16 weeks’ gestation
in China. We undertook a systematic review to compare different regimens of mifepristone
with prostaglandins for TOP at 10–16 weeks’ gestation.
Methods
We searched multiple electronic databases for English and Chinese language reports
(1990–2007) including MEDLINE, the Cochrane Library and the Chinese Biomedical Literature
Database. Included were trials comparing mifepristone with prostaglandins (misoprostol,
gemeprost or carboprost (PG05)) to each other for women at 10–16 weeks’ gestation.
Outcomes were successful abortion rates, induction-to-expulsion time, blood loss and
side effects. Data were processed with RevMan 5 software.
Results
Nineteen trials comparing mifepristone with prostaglandin (misoprostol and PG05) were
found of which 14 contributed to meta-analyses (4206 women). The quality of reports
was poor. The effectiveness of vaginal mifepristone/misoprostol was super than mifepristone/PG05
(RR 1.14, 95%CI 1.05–1.22) as was induction-to-expulsion time, blood loss and side
effects. When comparing misoprostol/mifepristone 150 mg to misoprostol/mifepristone 200 mg, no difference in TOP success rates were found (RR 0.98, 95%CI 0.96–1.01). Misoprostol
vaginally compared to orally significantly increased the TOP success rate (RR 1.12,
95%CI 1.01–1.24). Gastrointestinal symptoms and fever occurred more often in misoprostol
oral group (RR 1.67, 95%CI 1.46–1.91).
Conclusions
Medical regimens of mifepristone/prostaglandins were effective and safe for TOP at
10–16 weeks’ gestation. Misoprostol was super than PG05, and misoprostol vaginally
was found to have better effectiveness than misoprostol orally. Further research should
evaluate the relative effectiveness of medical methods compared to surgery.
Keywords
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Article info
Publication history
Published online: June 27, 2011
Accepted:
June 9,
2011
Received in revised form:
May 19,
2011
Received:
June 17,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
