Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 408-411, December 2008

High-Dose Misoprostol as An Alternative Therapy After Failed Medical Abortion

  • Yiu-Tai Li

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Guang-Qiong Hou

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Tien-Hui Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Yi-Chih Chu

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Ta-Chin Lin

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Long-Ching Kuan

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Mau Lin

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
  • ,
  • Shu-Feng Huang

      Affiliations

    • Department of Family Medicine, Kuo General Hospital, Tainan, Taiwan
    • Corresponding Author InformationCorrespondence to Dr Shu-Feng Huang, Department of Family Medicine, Kuo General Hospital, 22, Ming-Sheng Road, Section 2, Tainan 700, Taiwan
  • ,
  • Fu-Min Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Hospital, Taipei, Taiwan
  • ,
  • Tsung-Cheng Kuo

      Affiliations

    • Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan

Accepted 27 August 2008.

Article Outline

SUMMARY 

Objective

The aim of this study was to determine the complete abortion rate for the vaginal administration of high-dose misoprostol after a failed medical abortion.

Materials and Methods

When their medical abortions failed after the conventional oral administration of mifepristone and misoprostol, participants then received 1,000 μg of misoprostol vaginally. The efficacy and side effects of this treatment were evaluated.

Results

Twenty-seven women who failed to abort after the conventional administration of mifepristone and misoprostol were enrolled in this trial. Fourteen days after the vaginal administration of 1,000 μg misoprostol, the overall complete expulsion rate had reached 88.8% (24/27). Most adverse effects were mild to moderate and did not require treatment.

Conclusion

The vaginal administration of 1,000 μg misoprostol as a salvage therapy after a failed medical abortion appears to be a safe and highly effective alternative to surgical intervention.

Key Words:  medical abortion , mifepristone , misoprostol

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References 

  1. Lin HW , Chien TY , Jeng CJ , Chen SC , Chen HF , Hwang JL . Comparison of two doses of mifepristone in combination with misoprostol for early pregnancy termination . Taiwan J Obstet Gynecol . 2002;41:155–161
  2. World Health Organisation Task Force on Post-ovulatory Methods of Fertility Regulation  . Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomised trial . BJOG . 2000;107:524–530
  3. Kahn JG, Becker BJ, MacIsaa L, Amory JK, Neuhaus J, Olkin I, et al. The efficacy of medical abortion: a meta-analysis . Contraception . 2000;61:29–40
  4. Marions L . Mifepristone dose in the regimen with misoprostol for medical abortion . Contraception . 2006;74:21–25
  5. McKinley C , Thong KJ , Baird DT . The effect of dose of mifepristone and gestation on the efficacy of medical abortion with mifepristone and misoprostol . Hum Reprod . 1993;8:1502–1505
  6. Li YT , Chen TH , Kuo TC . Vaginal misoprostol for salvage therapy after failed medical abortion . Int J Gynaecol Obstet . 2007;96:52–53
  7. Katz J , Melzack R . Measurement of pain . Surg Clin North Am . 1999;79:231–252
  8. El-Refaey H , Rajasekar D , Abdalla M , Calder L , Templeton A . Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol . N Engl J Med . 1995;332:983–987
  9. Peyron R , Aubeny E , Targosz V , et al.   Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol . N Engl J Med . 1993;328:1509–1513
  10. Carbonell JLL , Rodriguez J , Aragon S , et al.   Vaginal misoprostol 1000 mg for early abortion . Contraception . 2001;63:131–136
  11. Li YT , Kuo TC , Chen FM , Chu YC , Hou SC . Mifepristone and misoprostol induced abortion with large myomatous uterus . Taiwan J Obstet Gynecol . 2005;44:175–176

PII: S1028-4559(09)60007-3

doi:10.1016/S1028-4559(09)60007-3

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 408-411, December 2008