The clinical effects of dosage during the period of treatment of Lithospermum Ruderale extract-a kind of Chinese traditional herbal medicine-on medicinal abortion induced by mifepristone and misoprostol were studied. ...The clinical effects of dosage during the period of treatment of Lithospermum Ruderale extract-a kind of Chinese traditional herbal medicine-on medicinal abortion induced by mifepristone and misoprostol were studied. Lithospermum Ruderale extract was administrated 3 d before, 3 d after or 3 d before plus 3 d after the administration of misoprostol respectively. The dose of Lithospermum Ruderale extract was 50 g, 75 g or 100 g respectively. Thus 1 350 women of early pregnancy were grouped into 9 groups and observed. The results showed that the effects of Lithospermum Ruderale used 3 d before, and 3 d before plus 3 d after (6 days misoprostol were significantly better than those only used 3 d after misoprostol both for complete abortion and bleeding (P<0.05). The dosage between 50 g and 100 g made no significant difference in clinical effects. Therefore it is reasonable to use 50 g Lithospermum Ruderale before misoprostol to improve medicinal abortion.展开更多
Early pregnancies(<42d)in 600 women were terminated respectively by mifepristone and Lithospermum Ruderal with misoprostol or mifepristone with misoprostol. The results showed that the rate of complete abortion(99....Early pregnancies(<42d)in 600 women were terminated respectively by mifepristone and Lithospermum Ruderal with misoprostol or mifepristone with misoprostol. The results showed that the rate of complete abortion(99.00%)of 300 women by mifepristone and Lithospermum Ruderal with misoprostol was significantly higher than that (92. 33%)of the other 300 women by mifepristone with misoprostol(P<0.01).The average length of time of embryo removal(54.01±7.55 h)and the rate of embryo removal (82.33%)within 6 hours after administration of misoprostol of the former were significantly shorter and higher than those(56.41±9.93 h and 72.67%) of the latter(P<0.05 respectively).The average length of the bleeding time of the former(7.01±3.11d)was significantly shorter than that(8.09±5.63d)of the latter(P<0.05).The recovery of the menstruation of both was not significantly different from each other(P>0.05).In all, the medical abortion by mifepristone and Lithospermum Ruderal with misoprostol was even more successful,with less bleeding time.Therefore it is essential to make researches on the auxiliary effects of Lithospermum Ruderal on the medical abortion by mifepristone with misoprostol.展开更多
To determine the effect of insulin like growth factor Ⅱ(IGF Ⅱ) upon the maintenance of decidua in early pregnancy and its relationship with progesterone, as well as its role in medical abortion. Materials & ...To determine the effect of insulin like growth factor Ⅱ(IGF Ⅱ) upon the maintenance of decidua in early pregnancy and its relationship with progesterone, as well as its role in medical abortion. Materials & Methods Decidua tissue was obtained from 28 women who undergoing surgical abortion and 39 for medical abortion respectively at 5~7 weeks of gestation. The extracted total RNA was reversely transcripted and amplified by PCR with specific primers (IGF Ⅱ and β actin). The products were semi quantitated by MIAS 300 system and qualitatively analyzed by southern blotting. Results The expression of IGF Ⅱ gene in decidua from surgical abortion was significantly higher than that from medical abortion (P<0.05). The average IGF Ⅱ gene transcription values were 1.54±0.79 and 0.72±0.39 respectively. The results of southern blotting proved qualitatively that the RT PCR products were IGF Ⅱ cDNA. Conclusion IGF Ⅱ plays a role in the maintenance of decidua in early pregnancy. It may act as a mediator of progestin. It's also involved in the molecular mechanism of mifepristone.展开更多
Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy. Methods TRAP-SYBR Green assay was used to detect the expressi...Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy. Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group). Results Positive expression of chorion telomerase was significantly different between the experimental group (28%, 11/40) and the control group (73%, 29/40) (P〈0.05). While in decidua, the positive rate was 28% (11/40) in the experimental group and 20% (9/40) in the control group, there was no significant difference (P〉0.05). Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.展开更多
Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A t...Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A total of 213 pregnant women with amenorrhea of 34~69 d after caesarian section who asked for medical abortion were recruited, including 63 cases undergoing their second medical abortion. A total amount of mifeprisstone of 150 mg given in separate doses (25 mg×4 and 50 mg at the first time) was administered orally within 3 d, followed by misoprostol of 0.6 mg orally in the morning of d 3. Results The complete abortion rate was 92.5%, incomplete abortion was 4.7% and failure was 2.8%. Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section history. Its efficacy was similar to that for ordinary population. Its safety and effectiveness were satisfactory.展开更多
Objective:To study the safety of mifepristone on thyroid hormone level by using hyperthyroidism pregnant model in mouse to simulate the process of medical abortion and observe the changes of thyroid hormone during abo...Objective:To study the safety of mifepristone on thyroid hormone level by using hyperthyroidism pregnant model in mouse to simulate the process of medical abortion and observe the changes of thyroid hormone during abortion.Methods:A total of 60 female Institute of Cancer Research(ICR)mice aged 6-8 weeks were divided into control group,control group with 0 mgRU486 group(control-0 mgRU486),control group with 2 mgRU486 group(control-2 mgRU486),hyperthyroid pregnant mice with 0 mgRU486 group(hyper-0 mgRU486),hyperthyroid pregnant mice with 2 mgRU486 group(hyper-2 mgRU486),and hyperthyroid pregnant mice with 20 mgRU486 group(hyper-20 mgRU486).In the hyperthyroidism groups,L-thyroxine sodium was intraperitoneally injected every day at 30μg·kg^(−1)·day^(−1) until the end of the experiment.On the 7^(th) day of the experiment,free triiodothyronine(FT3),free tetraiodothyroxine(FT4),thyroxine(TT4),and thyroid-stimulating hormone(TSH)levels were tested.The mice in the control groups and those in the experimental groups were paired with the male mice(2:1)on the 10^(th) day of the experiment,and the caging was recorded.On the 8^(th) day of pregnancy(day 8),pregnant mice were subcutaneously injected with mifepristone in different doses and were sacrificed 6 h later.Pregnancy rate and the number of embryos were recorded.Thyroid tissues were observed by hematoxylin and eosin(HE)staining.Serum TSH level was determined by radioimmunoassay.Results:Six hours after injection with mifepristone,serum FT3,FT4,and TT4 levels of pregnant mice were all increased.The increased levels in the mice under hyperthyroidism were different from those in the control groups(P<0.05).There was no difference in the embryo number and pregnancy rate between the experimental and the control groups;HE staining indicated that there was no significant change in microscopic features before and after mifepristone administration.Conclusion:Serum thyroid hormone level of mice under hyperthyroidism was significantly increased after mifepristone administration.Therefore,mifepristone should be avoided when hyperthyroidism has not been controlled.展开更多
Objectives To study the relationship between serum nitric oxide (NO and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. Methods A total of 120 women having receiv...Objectives To study the relationship between serum nitric oxide (NO and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. Methods A total of 120 women having received medical abortions at random were recruited and divided into two groups: the one (Group A,n=60) taking 'Gong Fu Mixture(Uterus Recovering Mixture)' and the other (Group B,n=60) not taking it after abortion. On d 10, 20 and 30 after medical abortion, serum NO and plasma cGMP were tested before and after mifepristone administration and 10 d later by Gresis reaction method and radioimmunoassay respectively. Results NO concentration in serum and cGMP concentration in plasma decreased significantly after taking mifepristone given (P<0.05). Ten days later, the number of those with bleeding discontinuation in the group A was significantly greater than that in the group B (P<0.05). Serum NO level and plasma cGMP level in the group A decreased more significantly than those in the group B (P<0.05). Conclusion The slow decrease of serum NO and plasma cGMP is closely related to prolonged bleeding after medical abortion. “Gong Fu Mixture (uterus recovering mixture)” is effective in prevention and treatment of prolonged bleeding.展开更多
Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion (EMA) up to 9 weeks of gestation. Methods An audit was performed on a retrospect...Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion (EMA) up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women (67%) aged 20-30 years old, 22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol, 4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion, 7.2% incomplete abortion and O. 7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d (7 weeks) and two doses of misoprostol between 49 d and 63 d (7-9 weeks) of pregnancy.展开更多
A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, ...A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, Obstetrics and gynaecology department Pt BDS PGIMS Rohtak BACKGROUND: Vaginal misoprostol has been shown to be an effective single agent for medical agent for medical abortion. This randomized, placebo controlled trial compared a regimen of mefipristone and misoprostol with misoprostol alone for termination of early pregnancy. METHODS: 200 women with gestation <56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 ug vaginal misoprostol. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS: Successful medical abortions occurred in 96 out of 100 subjects (96%) after mifepristone followed by vaginal misoprostol. In all, 79 out of 100 subjects (79%) successfully aborted after placebo and vaginal misoprostol. The higher success rate of complete abortion with mifepristone and misoprostol regimen was statistically significant compared with the placebo and misoprostol regimen (p < 0.05). CONCLUSION: A regimen of mifepristone and misoprostol was significantly more effective for termination of pregnancies <56 days than misoprostol alone. The misoprostol alone regimen for termination of early pregnancy is not a very good method for medical abortion but 79% efficacy obtained with vaginal misoprostol alone may clinically acceptable when mifepristone is not available.展开更多
To inverstgate the safety, effectiveness and acceptability Of conbination Of mifepristone and misoproslol for termination of high-risk pregnancy (amenorrhea≤ 70 days ).Three hundred and eighty-eight high-risk pregnan...To inverstgate the safety, effectiveness and acceptability Of conbination Of mifepristone and misoproslol for termination of high-risk pregnancy (amenorrhea≤ 70 days ).Three hundred and eighty-eight high-risk pregnant women, complicated with scarreduterus, or reproductive tract malformation, or uterus fibromyoma, or histories of recentabortion or repeated abortions, or pregnancy during lactation, and having duration of gestation ranging from 34 to 69 days, were administered orally 150 mg mifepristone (50 mgat the first time, and then 25 mg q 12 h × 4), and 600 μg misoprostol on the third day.The complete abortion rate ωas 92. 3%, while the incomplete abortion rate was 6. 2%, ongoing and pregnancy rate was 1. 5%. It was shown that combination of mifepristone andmisoprostol was effective in inducing abortion Of those high-risk pregnancies. Theregimen's effectiveness for high-risk population was similar to that for general population. Its safety, effectiveness and acceptability were satifactory. In addition, the softenedand dilated cervix made it easier and less painful to make vacuum aspiration in case offailure of the abortion.展开更多
Background Experimental evidence indicates that cyclooxygenase-2 (COX-2) plays a critical role in blastocyst implantation; however, little is known of the role of COX-2 in unexplained recurrent spontaneous abortion ...Background Experimental evidence indicates that cyclooxygenase-2 (COX-2) plays a critical role in blastocyst implantation; however, little is known of the role of COX-2 in unexplained recurrent spontaneous abortion (URSA). Methods We evaluated the expression level and potential signaling pathway of COX-2 in 30 cases of URSA who were excluded the abnormality of chromosomes, anatomy, endocrine, infectious, autoimmune diseases and in 30 normal pregnancies. Results The mRNA and the protein expression level of COX-2 in the URSA group (-0.238±0.848, 0.368±0.089, respectively) were significantly lower than that in the control group (1.943±3.845, 1.046±0.108, respectively) (both, P 〈0.01). The expression of prostaglandins PGF2a, PGD2, PGE2, and PGI2, in the URSA group ((2326.0±295.6) pg/ml, (2164.0±240.5) pg/ml, (238.7±26.4) pg/ml, (2337.0±263.0) pg/ml, respectively) were significantly lower than that in the control group ((3450.0±421.7) pg/ml, (3174.0±415.6) pg/ml, (323.5±43.8) pg/ml, (3623.0±460.4) pg/ml, respectively) (P 〈0.05). The mRNA expression level of PPARI3 and RXRa (0.859±0.653, -0.172±0.752, respectively) in URSA group was significantly lower than that in the control group (1.554±1.735, 0.777±2.482, respectively) (both P 〈0.05). The mRNA and protein expression levels of vascular endothelial growth factor-A (VEGF-A) in the URSA group (2.010±1.522, 0.35±0.46) was significantly lower than that in the control group (4.569±2.430, 0.750±0.350) (both P 〈0.05). Conclusions COX-2 and the COX-2-derived PGI2 signaling pathway possibly play an important role in successful embryo implantation, and their decreased expression may result in URSA. The decreased expression may influence the expression of VEGF-A which interferes with placental angiogenesis causing failure of embryo implantation, leading to spontaneous abortion.展开更多
Objective To compare clinical efficacy of three cervical preparations for surgical evacuation in first trimester missed abortion. Methods Two hundred and ten women with early missed abortion were equally randomized...Objective To compare clinical efficacy of three cervical preparations for surgical evacuation in first trimester missed abortion. Methods Two hundred and ten women with early missed abortion were equally randomized into three groups. Three cervical preparations, Dilapan-dilator method (group A, n= 70), mifepristone method (group B, n= 70), and misoprostol method (group C, n= 70), were used 24 h before curettage for terminating missed abortion, respectively. Clinical outcomes and complications for these three methods were compared. Results No differences were found in rates of successful treatment among the three groups (P〉O.05). The incidence of fitting number 8 Hegar dilator was slightly high in group A, but it was not different compared with that in group B or group C (P〉0.05). Bleeding in previous 24 h in group C was significantly greater than that in group A or group B (P〈0.01). The cases of blood loss (〉50 ml) during evacuation in group B were more than those in group A (P〉0.05). Women in group B had less abdominal pain than those in group A or group C (P〈0.01). Side effects in group C were more than those in group A on nausea (P〈0.01), vomiting (P〈0.05), and diarrhea (P〈0.01). Group B had the highest acceptability among the three groups (P〈0.05). Conclusion Three methods have the similar clinical efficacies in cervical ripening for surgical treatment of early missed abortion. Based on individual characteristics, different approach would be chosen to avoid some adverse events and improve the clinical application of Dilapan-dilator.展开更多
Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A (n=30): vaginal misoprostol ...Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A (n=30): vaginal misoprostol (MP) 0.4 mg, 3 h before vacuum aspiration; group B(n=15): vaginal MP 0.4 mg every 3 h, up to 5 doses; group C(n=30): oral mifepristone (MF) 200 mg 36-48 h before vaginal MP 0.4 mg, MP was given every 3 h, up to 5 doses. Results Women in group A had the shortest interval of gestation tissue expulsion (3.2± 0.5 h) and the bleeding (3.2 ± 5.7 ml) during medical procedure, which were statistically significant in comparison with the other two groups (P〈0.001, P〈0.01, respectively). Success rates of groups A, B and C were 100%, 33.3% and 90.0%, respectively. Percentages of women need surgical interventions were similar in group B and group C(80.0%,76.7%, respectively). Bleeding during operation, pain after medical procedure and satisfaction presented no statistical significance among the 3 groups. Conclusion Vaginal MP followed by vacuum aspiration was valuable in safety, and efficacy, which led to less bleeding and a faster recovery.展开更多
基金This study was funded by National Family Planning Commission of China
文摘The clinical effects of dosage during the period of treatment of Lithospermum Ruderale extract-a kind of Chinese traditional herbal medicine-on medicinal abortion induced by mifepristone and misoprostol were studied. Lithospermum Ruderale extract was administrated 3 d before, 3 d after or 3 d before plus 3 d after the administration of misoprostol respectively. The dose of Lithospermum Ruderale extract was 50 g, 75 g or 100 g respectively. Thus 1 350 women of early pregnancy were grouped into 9 groups and observed. The results showed that the effects of Lithospermum Ruderale used 3 d before, and 3 d before plus 3 d after (6 days misoprostol were significantly better than those only used 3 d after misoprostol both for complete abortion and bleeding (P<0.05). The dosage between 50 g and 100 g made no significant difference in clinical effects. Therefore it is reasonable to use 50 g Lithospermum Ruderale before misoprostol to improve medicinal abortion.
文摘Early pregnancies(<42d)in 600 women were terminated respectively by mifepristone and Lithospermum Ruderal with misoprostol or mifepristone with misoprostol. The results showed that the rate of complete abortion(99.00%)of 300 women by mifepristone and Lithospermum Ruderal with misoprostol was significantly higher than that (92. 33%)of the other 300 women by mifepristone with misoprostol(P<0.01).The average length of time of embryo removal(54.01±7.55 h)and the rate of embryo removal (82.33%)within 6 hours after administration of misoprostol of the former were significantly shorter and higher than those(56.41±9.93 h and 72.67%) of the latter(P<0.05 respectively).The average length of the bleeding time of the former(7.01±3.11d)was significantly shorter than that(8.09±5.63d)of the latter(P<0.05).The recovery of the menstruation of both was not significantly different from each other(P>0.05).In all, the medical abortion by mifepristone and Lithospermum Ruderal with misoprostol was even more successful,with less bleeding time.Therefore it is essential to make researches on the auxiliary effects of Lithospermum Ruderal on the medical abortion by mifepristone with misoprostol.
基金Project is partly supported by Shanghai Family Planning Commission
文摘To determine the effect of insulin like growth factor Ⅱ(IGF Ⅱ) upon the maintenance of decidua in early pregnancy and its relationship with progesterone, as well as its role in medical abortion. Materials & Methods Decidua tissue was obtained from 28 women who undergoing surgical abortion and 39 for medical abortion respectively at 5~7 weeks of gestation. The extracted total RNA was reversely transcripted and amplified by PCR with specific primers (IGF Ⅱ and β actin). The products were semi quantitated by MIAS 300 system and qualitatively analyzed by southern blotting. Results The expression of IGF Ⅱ gene in decidua from surgical abortion was significantly higher than that from medical abortion (P<0.05). The average IGF Ⅱ gene transcription values were 1.54±0.79 and 0.72±0.39 respectively. The results of southern blotting proved qualitatively that the RT PCR products were IGF Ⅱ cDNA. Conclusion IGF Ⅱ plays a role in the maintenance of decidua in early pregnancy. It may act as a mediator of progestin. It's also involved in the molecular mechanism of mifepristone.
文摘Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy. Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group). Results Positive expression of chorion telomerase was significantly different between the experimental group (28%, 11/40) and the control group (73%, 29/40) (P〈0.05). While in decidua, the positive rate was 28% (11/40) in the experimental group and 20% (9/40) in the control group, there was no significant difference (P〉0.05). Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.
文摘Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A total of 213 pregnant women with amenorrhea of 34~69 d after caesarian section who asked for medical abortion were recruited, including 63 cases undergoing their second medical abortion. A total amount of mifeprisstone of 150 mg given in separate doses (25 mg×4 and 50 mg at the first time) was administered orally within 3 d, followed by misoprostol of 0.6 mg orally in the morning of d 3. Results The complete abortion rate was 92.5%, incomplete abortion was 4.7% and failure was 2.8%. Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section history. Its efficacy was similar to that for ordinary population. Its safety and effectiveness were satisfactory.
文摘Objective:To study the safety of mifepristone on thyroid hormone level by using hyperthyroidism pregnant model in mouse to simulate the process of medical abortion and observe the changes of thyroid hormone during abortion.Methods:A total of 60 female Institute of Cancer Research(ICR)mice aged 6-8 weeks were divided into control group,control group with 0 mgRU486 group(control-0 mgRU486),control group with 2 mgRU486 group(control-2 mgRU486),hyperthyroid pregnant mice with 0 mgRU486 group(hyper-0 mgRU486),hyperthyroid pregnant mice with 2 mgRU486 group(hyper-2 mgRU486),and hyperthyroid pregnant mice with 20 mgRU486 group(hyper-20 mgRU486).In the hyperthyroidism groups,L-thyroxine sodium was intraperitoneally injected every day at 30μg·kg^(−1)·day^(−1) until the end of the experiment.On the 7^(th) day of the experiment,free triiodothyronine(FT3),free tetraiodothyroxine(FT4),thyroxine(TT4),and thyroid-stimulating hormone(TSH)levels were tested.The mice in the control groups and those in the experimental groups were paired with the male mice(2:1)on the 10^(th) day of the experiment,and the caging was recorded.On the 8^(th) day of pregnancy(day 8),pregnant mice were subcutaneously injected with mifepristone in different doses and were sacrificed 6 h later.Pregnancy rate and the number of embryos were recorded.Thyroid tissues were observed by hematoxylin and eosin(HE)staining.Serum TSH level was determined by radioimmunoassay.Results:Six hours after injection with mifepristone,serum FT3,FT4,and TT4 levels of pregnant mice were all increased.The increased levels in the mice under hyperthyroidism were different from those in the control groups(P<0.05).There was no difference in the embryo number and pregnancy rate between the experimental and the control groups;HE staining indicated that there was no significant change in microscopic features before and after mifepristone administration.Conclusion:Serum thyroid hormone level of mice under hyperthyroidism was significantly increased after mifepristone administration.Therefore,mifepristone should be avoided when hyperthyroidism has not been controlled.
文摘Objectives To study the relationship between serum nitric oxide (NO and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. Methods A total of 120 women having received medical abortions at random were recruited and divided into two groups: the one (Group A,n=60) taking 'Gong Fu Mixture(Uterus Recovering Mixture)' and the other (Group B,n=60) not taking it after abortion. On d 10, 20 and 30 after medical abortion, serum NO and plasma cGMP were tested before and after mifepristone administration and 10 d later by Gresis reaction method and radioimmunoassay respectively. Results NO concentration in serum and cGMP concentration in plasma decreased significantly after taking mifepristone given (P<0.05). Ten days later, the number of those with bleeding discontinuation in the group A was significantly greater than that in the group B (P<0.05). Serum NO level and plasma cGMP level in the group A decreased more significantly than those in the group B (P<0.05). Conclusion The slow decrease of serum NO and plasma cGMP is closely related to prolonged bleeding after medical abortion. “Gong Fu Mixture (uterus recovering mixture)” is effective in prevention and treatment of prolonged bleeding.
文摘Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion (EMA) up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women (67%) aged 20-30 years old, 22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol, 4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion, 7.2% incomplete abortion and O. 7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d (7 weeks) and two doses of misoprostol between 49 d and 63 d (7-9 weeks) of pregnancy.
文摘A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, Obstetrics and gynaecology department Pt BDS PGIMS Rohtak BACKGROUND: Vaginal misoprostol has been shown to be an effective single agent for medical agent for medical abortion. This randomized, placebo controlled trial compared a regimen of mefipristone and misoprostol with misoprostol alone for termination of early pregnancy. METHODS: 200 women with gestation <56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 ug vaginal misoprostol. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS: Successful medical abortions occurred in 96 out of 100 subjects (96%) after mifepristone followed by vaginal misoprostol. In all, 79 out of 100 subjects (79%) successfully aborted after placebo and vaginal misoprostol. The higher success rate of complete abortion with mifepristone and misoprostol regimen was statistically significant compared with the placebo and misoprostol regimen (p < 0.05). CONCLUSION: A regimen of mifepristone and misoprostol was significantly more effective for termination of pregnancies <56 days than misoprostol alone. The misoprostol alone regimen for termination of early pregnancy is not a very good method for medical abortion but 79% efficacy obtained with vaginal misoprostol alone may clinically acceptable when mifepristone is not available.
文摘To inverstgate the safety, effectiveness and acceptability Of conbination Of mifepristone and misoproslol for termination of high-risk pregnancy (amenorrhea≤ 70 days ).Three hundred and eighty-eight high-risk pregnant women, complicated with scarreduterus, or reproductive tract malformation, or uterus fibromyoma, or histories of recentabortion or repeated abortions, or pregnancy during lactation, and having duration of gestation ranging from 34 to 69 days, were administered orally 150 mg mifepristone (50 mgat the first time, and then 25 mg q 12 h × 4), and 600 μg misoprostol on the third day.The complete abortion rate ωas 92. 3%, while the incomplete abortion rate was 6. 2%, ongoing and pregnancy rate was 1. 5%. It was shown that combination of mifepristone andmisoprostol was effective in inducing abortion Of those high-risk pregnancies. Theregimen's effectiveness for high-risk population was similar to that for general population. Its safety, effectiveness and acceptability were satifactory. In addition, the softenedand dilated cervix made it easier and less painful to make vacuum aspiration in case offailure of the abortion.
文摘Background Experimental evidence indicates that cyclooxygenase-2 (COX-2) plays a critical role in blastocyst implantation; however, little is known of the role of COX-2 in unexplained recurrent spontaneous abortion (URSA). Methods We evaluated the expression level and potential signaling pathway of COX-2 in 30 cases of URSA who were excluded the abnormality of chromosomes, anatomy, endocrine, infectious, autoimmune diseases and in 30 normal pregnancies. Results The mRNA and the protein expression level of COX-2 in the URSA group (-0.238±0.848, 0.368±0.089, respectively) were significantly lower than that in the control group (1.943±3.845, 1.046±0.108, respectively) (both, P 〈0.01). The expression of prostaglandins PGF2a, PGD2, PGE2, and PGI2, in the URSA group ((2326.0±295.6) pg/ml, (2164.0±240.5) pg/ml, (238.7±26.4) pg/ml, (2337.0±263.0) pg/ml, respectively) were significantly lower than that in the control group ((3450.0±421.7) pg/ml, (3174.0±415.6) pg/ml, (323.5±43.8) pg/ml, (3623.0±460.4) pg/ml, respectively) (P 〈0.05). The mRNA expression level of PPARI3 and RXRa (0.859±0.653, -0.172±0.752, respectively) in URSA group was significantly lower than that in the control group (1.554±1.735, 0.777±2.482, respectively) (both P 〈0.05). The mRNA and protein expression levels of vascular endothelial growth factor-A (VEGF-A) in the URSA group (2.010±1.522, 0.35±0.46) was significantly lower than that in the control group (4.569±2.430, 0.750±0.350) (both P 〈0.05). Conclusions COX-2 and the COX-2-derived PGI2 signaling pathway possibly play an important role in successful embryo implantation, and their decreased expression may result in URSA. The decreased expression may influence the expression of VEGF-A which interferes with placental angiogenesis causing failure of embryo implantation, leading to spontaneous abortion.
基金supported by Science and Technology Planning Project of Guangdong Province,China (No. 2010B031600250)
文摘Objective To compare clinical efficacy of three cervical preparations for surgical evacuation in first trimester missed abortion. Methods Two hundred and ten women with early missed abortion were equally randomized into three groups. Three cervical preparations, Dilapan-dilator method (group A, n= 70), mifepristone method (group B, n= 70), and misoprostol method (group C, n= 70), were used 24 h before curettage for terminating missed abortion, respectively. Clinical outcomes and complications for these three methods were compared. Results No differences were found in rates of successful treatment among the three groups (P〉O.05). The incidence of fitting number 8 Hegar dilator was slightly high in group A, but it was not different compared with that in group B or group C (P〉0.05). Bleeding in previous 24 h in group C was significantly greater than that in group A or group B (P〈0.01). The cases of blood loss (〉50 ml) during evacuation in group B were more than those in group A (P〉0.05). Women in group B had less abdominal pain than those in group A or group C (P〈0.01). Side effects in group C were more than those in group A on nausea (P〈0.01), vomiting (P〈0.05), and diarrhea (P〈0.01). Group B had the highest acceptability among the three groups (P〈0.05). Conclusion Three methods have the similar clinical efficacies in cervical ripening for surgical treatment of early missed abortion. Based on individual characteristics, different approach would be chosen to avoid some adverse events and improve the clinical application of Dilapan-dilator.
文摘Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A (n=30): vaginal misoprostol (MP) 0.4 mg, 3 h before vacuum aspiration; group B(n=15): vaginal MP 0.4 mg every 3 h, up to 5 doses; group C(n=30): oral mifepristone (MF) 200 mg 36-48 h before vaginal MP 0.4 mg, MP was given every 3 h, up to 5 doses. Results Women in group A had the shortest interval of gestation tissue expulsion (3.2± 0.5 h) and the bleeding (3.2 ± 5.7 ml) during medical procedure, which were statistically significant in comparison with the other two groups (P〈0.001, P〈0.01, respectively). Success rates of groups A, B and C were 100%, 33.3% and 90.0%, respectively. Percentages of women need surgical interventions were similar in group B and group C(80.0%,76.7%, respectively). Bleeding during operation, pain after medical procedure and satisfaction presented no statistical significance among the 3 groups. Conclusion Vaginal MP followed by vacuum aspiration was valuable in safety, and efficacy, which led to less bleeding and a faster recovery.