Early abortion by mifepristone (RU 486) followed by vaginal gel (meteneprost) versus oral (misoprostol) prostaglandin

The present study was conducted to compare the therapeutic regimens of low- dose mifepristone (200 mg) plus vaginal meteneprost versus oral misoprostol in terms of efficacy and safety for medical termination of early pregnancy . A randomized clinical trial was conducted by the Department of Obstetrics and Gynecology at the All India Institute of Medical Sciences, New Delhi. A total of 101 subjects were enrolled within 56 days of amenorrhea. A singl e dose of 200 mg of mifepristone (RU 486) was given and, 48 hr later, prost aglandin was administered as either 5 mg of 9-methylene PGE(2) vaginal gel, meteneprost (classified as group I) or 600 mu g of oral PGE(1) derivative misoprostol (classified as group II). In group I, 50 subjects and in group II, 51 subjects were treated with the respective schedule. The success rate with mifepristone + misoprostol (group II) was 88.63% which was significan tly higher than that with mifepristone + meteneprost (group I) which was 82 % (p < 0.05). The average duration of bleeding in cases with complete abort ion was 8.95 +/- 5.67 and 9.77 +/- 6.51 in group I and II, respectively. Th ere were no serious side-effects. Only one subject in group I (2%) required blood transfusion for heavy bleeding. This study indicated that oral prost aglandin after a low dose of mifepristone (200 mg) could be developed into an effective method to terminate early pregnancy. Oral administration of bo th drugs would be a more convenient, feasible, private and acceptable regim en.