MEDICAL TERMINATION OF EARLY-PREGNANCY WITH MIFEPRISTONE (RU-486) FOLLOWED BY A PROSTAGLANDIN ANALOG - STUDY IN 16,369 WOMEN

被引:151
作者
ULMANN, A
SILVESTRE, L
CHEMAMA, L
REZVANI, Y
RENAULT, M
AGUILLAUME, CJ
BAULIEU, EE
机构
[1] LABS ROUSSEL,F-75006 PARIS,FRANCE
[2] INSERM,U33,HORMONES LAB,F-94275 LE KREMLIN BICETR,FRANCE
[3] UN,NEW YORK,NY 10017
关键词
RU-486; PREGNANCY TERMINATION; PROSTAGLANDINS; MIFEPRISTONE; GEMEPROST; SULPROSTONE;
D O I
10.3109/00016349209021052
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
We report the results of a large-scale trial with mifepristone (RU 486) followed by the administration of a prostaglandin (PG) analogue for the medical termination of early pregnancy. Altogether, 16,173 patients from 300 centers were evaluated. 48 women (0.3%) were lost to follow-up prior to, and 416 (2.6%) after the PG administration, and therefore the efficacy was evaluated in 15,709 women. Overall, the success rate was 95.3%, with no statistical difference regarding the nature and dose of PG used. The median duration of bleeding was 8 days, being 12 days or less in 89.7% of the women. Bleeding was significant enough to necessitate a vacuum aspiration or a dilatation and curettage in 0.8% of the cases. A blood transfusion was necessary in 0.1% of the women (11 patients). Serious cardio-vascular side-effects were reported in 4 cases after the PG (sulprostone) injection: they consisted of one acute myocardial infarction attributed to a coronary spasm, and in marked hypotension in the other 3 woman. All patients recovered uneventfully. In conclusion, RU 486 followed by a PG analogue provides an efficient and safe medical alternative to surgery for early pregnancy termination, provided that the recommended protocol is adequately followed and the contraindications to prostaglandins are respected.
引用
收藏
页码:278 / 283
页数:6
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