Effects of a prolonged, 72 hours, interval between mifepristone and gemeprost in second trimester termination of pregnancy: a retrospective analysis

Abstract

Objective: To evaluate if the 72 hours interval between mifepristone and gemeprost has a similar efficacy compared to the 48 hours interval for second trimester termination of pregnancy

Study Design: Two-hundred and fifteen consecutive pregnant women, admitted to our hospital, for second trimester TOP, were included in this retrospective analysis. Standard protocol was followed for all patients. On the first day of the procedure oral mifepristone 200 mg was administered. After 72 (group A, n = 78) or 48 hours (group B, n = 113) women were admitted for administration of gemeprost 1 mg pessary as per protocol. The induction to abortion time was defined as the interval between the insertion of the first gemeprost pessary and the expulsion of the fetus.

Results: There are no significant differences in the number of pessaries in the two groups. The induction to abortion interval was longer in group A than in group B. Twenty-one women required surgical evacuation of the uterus for retained placenta or incomplete abortion without difference between groups.

Conclusion: A 48-hours interval between mifepristone and gemeprost leads to better results than a 72-hours interval, with a shorter abortion length and represents the elective method for second trimester TOP.

Chinese abstract

目的：评价米非司酮和吉美前列素的使用间隔时间为72小时与48小时相比，其终止孕中期妊娠的效果是否相似。

研究设计：我院收治的215名要求终止孕中期妊娠的妇女被纳入这项回顾性分析。所有的患者均使用标准治疗方案。第1天口服米非司酮200mg，72小时（A组，n=78）或48小时（B组，n=113）后阴道放置吉美前列素栓1mg。诱导流产的时间定义为放置第1枚吉美前列素栓剂与胚胎排除的时间间隔。

结果：两组放置吉美前列素栓剂的数量无统计学差异。A组诱导流产的时间并不长于B组。21名妇女因胎盘滞留或不全流产需要手术清宫，且两组间无统计学差异。

结论：米非司酮和吉美前列素的使用间隔时间为48小时比72小时的效果更佳，前者流产时间更短，代表了孕中期终止妊娠的更佳选择。

• Gemeprost
• mifepristone
• second trimester termination of pregnancy
• second trimester abortion