Pilot study on the use of a two-week course of oral misoprostol in patients after termination of pregnancy with mifepristone and misoprostol

Abstract

Twenty women who requested early first trimester termination of pregnancy were recruited to study the tolerability of a 2-week course of oral misoprostol after termination of pregnancy by mifepristone and vaginal misoprostol. Ten patients (50%) complained of mild diarrhea during the 2- week course of misoprostol. Otherwise, there were no other significant side effects. The 2-week course of misoprostol was well tolerated by women who underwent early first trimester termination of pregnancy with mifepristone and misoprostol. | A pilot study was conducted to assess whether prolonged use of misoprostol is well tolerated by women who have undergone termination of an early pregnancy with mifepristone and misoprostol and if this regimen increases the complete abortion rate and decreases the duration of bleeding. Enrolled were 20 women from Hong Kong and Shanghai with a menstrual delay of 21 days or less; the mean duration of pregnancy was 40.8 +or- 4.7 days. Women were given 200 mg of oral mifepristone, followed 48 hours later by 400 mcg of vaginal misoprostol. Oral misoprostol (400 mcg) was continued twice daily for 2 weeks. 11 women (55%) aborted during the initial 4-hour observation period and all had complete abortion. The mean duration of bleeding was 25.2 +or- 4.3 days. Nausea, diarrhea, and lower abdominal pain were the most common side effects of misoprostol, but all women were able to complete the 2-week course of treatment. On the basis of the findings of this pilot study, a prospective, randomized study with a larger number of patients is recommended to confirm whether a 2-week course of misoprostol can increase the abortion rate and decrease the duration of postabortal bleeding.