A RANDOMIZED STUDY OF 2 DOSES OF GEMEPROST IN COMBINATION WITH MIFEPRISTONE FOR INDUCTION OF ABORTION IN THE 2ND-TRIMESTER OF PREGNANCY

Two regimens of the prostaglandin E(1) analogue, gemeprost, in combina tion with mifepristone were compared in a randomised trial for termina tion of pregnancy between 12-19 weeks. Thirty-six hours after treatmen t with 200 mg mifepristone, women were allocated at random to receive either 4 x 1 mg (Group I) or 4 x 0.5 mg (Group II) gemeprost by vagina l pessary every 6 hours (n = 50 in each group). If abortion had not oc curred after 24 h, 5 x 1 mg of gemeprost was administered every 3 h to both groups of women. Although the median abortion interval was sligh tly shorter in the 1 mg group (7.8 h vs. 8.4 h, p = 0.5), the cumulati ve abortion rates at 24 h were similar (98 % vs. 96 %). Women in Group I required significantly more gemeprost to induce abortion than Group II (p < 0.0001). Parous women in both groups required significantly l ess of the prostaglandin to induce abortion. In Group II, the median a bortion interval was significantly longer in primigravidae than multig ravidae (9.5 h vs. 6.1 h; p < 0.02). There were no significant differe nces between the groups in the incidence of vomiting, diarrhoea or the request for analgesia. The results suggest that in parous women, the dose of gemeprost can be reduced to 0.5 mg every 6 h within the first 24 h without loss of clinical efficacy.