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D T Baird - One of the best experts on this subject based on the ideXlab platform.

  • a randomised study of misoprostol and Gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy
    British Journal of Obstetrics and Gynaecology, 2002
    Co-Authors: Julia Bartley, D T Baird
    Abstract:

    Objective To compare the effectiveness of Gemeprost and misoprostol as prostaglandins used in combination with mifepristone for induction of mid-trimester termination. Design Randomised trial. Setting Scottish teaching hospital. Sample One hundred women undergoing abortion between 12 and 20 weeks. Methods Each woman received 200 mg mifepristone and 36–48 hours later either 1 mg Gemeprost vaginal pessary every 6 hours for 18 hours or 4 × 200 μg misoprostol tablets vaginally followed by 2 × 200 μg misoprostol tablets orally every 3 hours for 12 hours. Success was defined as the percentage of women aborted within 24 hours of the first administration of prostaglandin. Main outcome measures Prostaglandin–abortion interval and side effects. Results There were no significant differences in median prostaglandin–abortion interval between Gemeprost (6.6 hours 95% CI 6.0–10.7) and misoprostol (6.1 hours 95% CI 5.5–7.5) (P= 0.22). The cumulative abortion rates at 24 hours (96%vs 94%, respectively), the surgical evacuation rates (12% and 10%) and the incidence of vomiting, diarrhoea and pain were similar. Conclusion Two hundred milligrammes of mifepristone followed 36–48 hours later by either vaginal Gemeprost or misoprostol is a highly effective way of inducing abortion in the second trimester of pregnancy.

  • second trimester medical abortion with mifepristone and Gemeprost a review of 956 cases
    Contraception, 2001
    Co-Authors: O S Tang, K J Thong, D T Baird
    Abstract:

    The treatment outcomes of 956 women undergoing second trimester termination of pregnancy with mifepristone and Gemeprost were studied. The median gestational age was 16 weeks (range: 12–24 weeks). All women were treated with 200 mg mifepristone orally, followed 36 h later with 1 mg vaginal Gemeprost administered every 6 h to a maximum of 4 doses in the first 24 h. A second course of 1 mg vaginal Gemeprost was given 3-hourly in the next 12 h, if abortion had not occurred. Overall, 96.4% and 98.8% of the women aborted within 24 and 36 h, respectively. The median induction-to-abortion interval was 7.8 h (range: 0.5–109.9 h). The induction-abortion interval was longer in nulliparous women and women with a gestation age 17 weeks or above. Surgical evacuation of the uterus was performed in 11.5% of women for incomplete abortion or retained placenta. More multiparous women (16.7%) required surgical evacuation of uterus than did nulliparous women (7.3%; p <0.001). Ten (0.1%) women failed to abort with Gemeprost and required other methods for abortion. In conclusion, a combination of mifepristone and Gemeprost is a safe, effective, and noninvasive method of medical abortion for second trimester pregnancy.

  • Second trimester medical abortion with mifepristone and Gemeprost: a review of 956 cases
    Contraception, 2001
    Co-Authors: O S Tang, K J Thong, D T Baird
    Abstract:

    The treatment outcomes of 956 women undergoing second trimester termination of pregnancy with mifepristone and Gemeprost were studied. The median gestational age was 16 weeks (range: 12–24 weeks). All women were treated with 200 mg mifepristone orally, followed 36 h later with 1 mg vaginal Gemeprost administered every 6 h to a maximum of 4 doses in the first 24 h. A second course of 1 mg vaginal Gemeprost was given 3-hourly in the next 12 h, if abortion had not occurred. Overall, 96.4% and 98.8% of the women aborted within 24 and 36 h, respectively. The median induction-to-abortion interval was 7.8 h (range: 0.5–109.9 h). The induction-abortion interval was longer in nulliparous women and women with a gestation age 17 weeks or above. Surgical evacuation of the uterus was performed in 11.5% of women for incomplete abortion or retained placenta. More multiparous women (16.7%) required surgical evacuation of uterus than did nulliparous women (7.3%; p

  • A randomised study of two doses of Gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy
    Contraception, 1996
    Co-Authors: K J Thong, P. Lynch, D T Baird
    Abstract:

    Abstract Two regimens of the prostaglandin E 1 analogue, Gemeprost, in combination with mifepristone were compared in a randomised trial for termination of pregnancy between 12–19 weeks. Thirty-six hours after treatment with 200 mg mifepristone, women were allocated at random to receive either 4 × 1 mg (Group I) or 4 × 0.5 mg (Group II) Gemeprost by vaginal pessary every 6 hours (n = 50 in each group). If abortion had not occurred after 24 h, 5 × 1 mg of Gemeprost was administered every 3 h to both groups of women. Although the median abortion interval was slightly shorter in the 1 mg group (7.8 h vs. 8.4 h, p=0.5), the cumulative 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 There were no significant differences 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.

  • changes in the concentration of alpha fetoprotein and placental hormones following two methods of medical abortion in early pregnancy
    British Journal of Obstetrics and Gynaecology, 1993
    Co-Authors: Joo K Thong, Jane E Norman, D T Baird
    Abstract:

    Objective Measurement of alpha-fetoprotein (AFP) was used to investigate the occurrence of feto-maternal haemorrhage in women undergoing medical abortion. Design Three groups of women with amenorrhoea of 56 or less days were studied. A control and a mifepristone group had two blood samples taken 48 h apart. Women undergoing medical abortion with Gemeprost had two blood samples taken 24 h apart. Setting Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Subjects Three hundred and thirty-five women requesting abortion. Interventions Blood samples taken at 24 h or 48 h apart. Measurements and main results The rise in concentration of AFP in plasma was much higher (P= 0.01) in the two groups of women in whom abortion was induced by Gemeprost or mifepristone than in control women. Whereas only 5% of women in the control group had a significant rise in AFP, 27% and 33% of women in the mifepristone and Gemeprost groups, respectively, had a rise in AFP level which exceeded the 95th centile (≥38%). The concentration of hCG rose by 48 h in both control and mifepristone groups. Progesterone remained unchanged, and oestradiol decreased (P<0.02) in the mifepristone group. By 24 h, there was a significant fall in the concentrations of hCG, progesterone and oestradiol in the group who had aborted after being given Gemeprost. Conclusions Anti-D prophylaxis must be administered to rhesus negative women to avoid rhesus iso-immunisation.

K J Thong - One of the best experts on this subject based on the ideXlab platform.

  • second trimester medical abortion with mifepristone and Gemeprost a review of 956 cases
    Contraception, 2001
    Co-Authors: O S Tang, K J Thong, D T Baird
    Abstract:

    The treatment outcomes of 956 women undergoing second trimester termination of pregnancy with mifepristone and Gemeprost were studied. The median gestational age was 16 weeks (range: 12–24 weeks). All women were treated with 200 mg mifepristone orally, followed 36 h later with 1 mg vaginal Gemeprost administered every 6 h to a maximum of 4 doses in the first 24 h. A second course of 1 mg vaginal Gemeprost was given 3-hourly in the next 12 h, if abortion had not occurred. Overall, 96.4% and 98.8% of the women aborted within 24 and 36 h, respectively. The median induction-to-abortion interval was 7.8 h (range: 0.5–109.9 h). The induction-abortion interval was longer in nulliparous women and women with a gestation age 17 weeks or above. Surgical evacuation of the uterus was performed in 11.5% of women for incomplete abortion or retained placenta. More multiparous women (16.7%) required surgical evacuation of uterus than did nulliparous women (7.3%; p <0.001). Ten (0.1%) women failed to abort with Gemeprost and required other methods for abortion. In conclusion, a combination of mifepristone and Gemeprost is a safe, effective, and noninvasive method of medical abortion for second trimester pregnancy.

  • Second trimester medical abortion with mifepristone and Gemeprost: a review of 956 cases
    Contraception, 2001
    Co-Authors: O S Tang, K J Thong, D T Baird
    Abstract:

    The treatment outcomes of 956 women undergoing second trimester termination of pregnancy with mifepristone and Gemeprost were studied. The median gestational age was 16 weeks (range: 12–24 weeks). All women were treated with 200 mg mifepristone orally, followed 36 h later with 1 mg vaginal Gemeprost administered every 6 h to a maximum of 4 doses in the first 24 h. A second course of 1 mg vaginal Gemeprost was given 3-hourly in the next 12 h, if abortion had not occurred. Overall, 96.4% and 98.8% of the women aborted within 24 and 36 h, respectively. The median induction-to-abortion interval was 7.8 h (range: 0.5–109.9 h). The induction-abortion interval was longer in nulliparous women and women with a gestation age 17 weeks or above. Surgical evacuation of the uterus was performed in 11.5% of women for incomplete abortion or retained placenta. More multiparous women (16.7%) required surgical evacuation of uterus than did nulliparous women (7.3%; p

  • A randomised study of two doses of Gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy
    Contraception, 1996
    Co-Authors: K J Thong, P. Lynch, D T Baird
    Abstract:

    Abstract Two regimens of the prostaglandin E 1 analogue, Gemeprost, in combination with mifepristone were compared in a randomised trial for termination of pregnancy between 12–19 weeks. Thirty-six hours after treatment with 200 mg mifepristone, women were allocated at random to receive either 4 × 1 mg (Group I) or 4 × 0.5 mg (Group II) Gemeprost by vaginal pessary every 6 hours (n = 50 in each group). If abortion had not occurred after 24 h, 5 × 1 mg of Gemeprost was administered every 3 h to both groups of women. Although the median abortion interval was slightly shorter in the 1 mg group (7.8 h vs. 8.4 h, p=0.5), the cumulative 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 There were no significant differences 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.

  • Induction of second trimester abortion with mifepristone and Gemeprost
    International Journal of Gynecology & Obstetrics, 1994
    Co-Authors: K J Thong, David T. Baird
    Abstract:

    Objective To determine the efficacy of a new regimen of the antiprogestogen mifepristone and Gemeprost for midtrimester abortion. Design Prospective study. Setting Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Subjects One hundred women undergoing midtrimester abortion. Interventions Women were pretreated with 200 mg mifepristone 36 h before prostaglandin; 1 mg Gemeprost was administered every 6 h for the first 24 h. If abortion had not occurred, 1 mg Gemeprost was administered 3 hourly over the next 12 h. Measurement and main results Ninety-six percent and 99% women aborted within 24 h and 48 h, respectively. The median prostaglandin-abortion interval was significantly shorter in multigravidae compared to primigravida (6.6 vs 8.2 h, P

  • induction of second trimester abortion with mifepristone and Gemeprost
    British Journal of Obstetrics and Gynaecology, 1993
    Co-Authors: K J Thong, D T Baird
    Abstract:

    Objective To determine the efficacy of a new regimen of the antiprogestogen mifepristone and Gemeprost for midtrimester abortion. Design Prospective study. Setting Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Subjects One hundred women undergoing midtrimester abortion. Interventions Women were pretreated with 200 mg mifepristone 36 h before prostaglandin; 1 mg Gemeprost was administered every 6 h for the first 24 h. If abortion had not occurred, 1 mg Gemeprost was administered 3 hourly over the next 12 h. Measurement and main results Ninety-six percent and 99% women aborted within 24 h and 48 h, respectively. The median prostaglandin-abortion interval was significantly shorter in multigravidae compared to primigravida (6.6 vs 8.2 h, P<0.01). The median number of Gemeprost pessaries to induce abortion was only two and 47% of women required one pessary. The incidence of vomiting and diarrhoea was 31% and 5%, respectively. Eighty-four percent of women required intramuscular diamorphine for analgesia. Thirty-three percent of women required an evacuation of the uterus following abortion. Conclusions The shortened induction-delivery interval following pretreatment with mifepristone makes it possible to conduct midtrimester abortion on a daycare basis.

Terence T. Lao - One of the best experts on this subject based on the ideXlab platform.

Lawrence C. H. Tang - One of the best experts on this subject based on the ideXlab platform.

  • Vaginal Misoprostol compared with vaginal Gemeprost in termination of second trimester pregnancy: A randomized trial
    Contraception, 1998
    Co-Authors: Ks Wong, C.s.w. Ngai, A. Y. K. Wong, Lawrence C. H. Tang
    Abstract:

    A prospective randomized trial was conducted in 140 women to compare the efficacy of vaginal Gemeprost with vaginal misoprostol for termination of second trimester pregnancy. Women requesting termination of second trimester pregnancy were randomized into two groups. Group A women were given 1 mg vaginal Gemeprost every 3 h for a maximum of five doses in the first 24 h, whereas group B women were given 400 micrograms vaginal misoprostol every 3 h for a maximum of five doses in 24 h. The median induction-abortion interval in the vaginal misoprostol group (14.1 h) was significantly shorter than that in the Gemeprost group (19.5 h). The percentage of women who achieved successful abortion within 24 h in the misoprostol group (80.0%) was significantly higher than that in the Gemeprost group (58.6%). There was no significant difference in the incidence of side effects between the two groups except for diarrhea, which was more common in the Gemeprost group. The incidence of fever was more common in the misoprostol group. It is concluded that vaginal misoprostol is more effective than Gemeprost in termination of second trimester pregnancy.

  • Termination of second trimester pregnancy with Gemeprost and misoprostol: a randomized double-blind placebo-controlled trial.
    Contraception, 1996
    Co-Authors: Ks Wong, Ks Chan, C.s.w. Ngai, Lawrence C. H. Tang
    Abstract:

    A prospective randomized double-blind placebo-controlled trial was conducted in 70 subjects to determine whether pre-treatment with misoprostol could facilitate termination of second trimester pregnancy by Gemeprost. The women received either 400 μg oral misoprostol or placebo tablets 12 hours before the administration of vaginal pessary of Gemeprost 1 mg every 3 hours. There were no significant differences in induction-abortion interval and the amount of Gemeprost required between the misoprostol and the placebo group. There was no significant difference in the incidence of side effects or analgesic requirement between the two groups. We conclude that oral misoprostol is not useful in facilitating termination of second trimester pregnancy by Gemeprost.

Ks Wong - One of the best experts on this subject based on the ideXlab platform.

  • Vaginal misoprostol compared with vaginal Gemeprost in termination of second trimester pregnancy: A randomized trial
    'Elsevier BV', 1998
    Co-Authors: Ks Wong, Wong Ayk, Ngai Csw, Tang Lch
    Abstract:

    A prospective randomized trial was conducted in 140 women to compare the efficacy of vaginal Gemeprost with vaginal misoprostol for termination of second trimester pregnancy. Women requesting termination of second trimester pregnancy were randomized into two groups. Group A women were given 1 mg vaginal Gemeprost every 3 h for a maximum of five doses in the first 24 h, whereas group B women were given 400 μg vaginal misoprostol every 3 h for a maximum of five doses in 24 h. The median induction-abortion interval in the vaginal misoprostol group (14.1 h) was significantly shorter than that in the Gemeprost group (19.5 h). The percentage of women who achieved successful abortion within 24 h in the misoprostol group (80.0%) was significantly higher than that in the Gemeprost group (58.6%). There was no significant difference in the incidence of side effects between the two groups except for diarrhea, which was more common in the Gemeprost group. The incidence of fever was more common in the misoprostol group. It is concluded that vaginal misoprostol is more effective than Gemeprost in termination of second trimester pregnancy. | The efficacies of vaginal Gemeprost and vaginal misoprostol for the termination of second-trimester pregnancies were compared in a prospective, randomized trial conducted in Hong Kong, China. 140 women 16-40 years of age requesting pregnancy termination at gestational ages of 14-20 weeks were allocated to receive either 1 mg of Gemeprost every 3 hours up to 5 doses (n = 70) or 400 mcg of misoprostol every 3 hours up to 5 doses (n = 70). 56 women (80.0%) in the misoprostol group and 41 (58.6%) in the Gemeprost group aborted within 24 hours. In primigravidas, the rate of successful abortion was significantly higher in the misoprostol group (83.3%) than the Gemeprost group (55.3%). There were no significant between-group differences in this rate for multigravid women. The median induction-abortion interval was significantly shorter in the misoprostol group (14.1 hours) than the Gemeprost group (19.5 hours). Blood loss during the procedure was similar in both groups. Although there was no significant difference in the incidence of side effects, diarrhea was less common in misoprostol acceptors (24.3%) than in women who received Gemeprost (40.0%). In addition to being more effective at inducing abortion, misoprostol is substantially less expensive than Gemeprost and does not require refrigerated transport and storage facilities. Thus, misoprostol, with or without mifepristone, should be the drug of choice for termination of mid-trimester pregnancies. Further studies are needed, however, to determine the optimal dose and frequency of administration.link_to_subscribed_fulltex

  • Vaginal Misoprostol compared with vaginal Gemeprost in termination of second trimester pregnancy: A randomized trial
    Contraception, 1998
    Co-Authors: Ks Wong, C.s.w. Ngai, A. Y. K. Wong, Lawrence C. H. Tang
    Abstract:

    A prospective randomized trial was conducted in 140 women to compare the efficacy of vaginal Gemeprost with vaginal misoprostol for termination of second trimester pregnancy. Women requesting termination of second trimester pregnancy were randomized into two groups. Group A women were given 1 mg vaginal Gemeprost every 3 h for a maximum of five doses in the first 24 h, whereas group B women were given 400 micrograms vaginal misoprostol every 3 h for a maximum of five doses in 24 h. The median induction-abortion interval in the vaginal misoprostol group (14.1 h) was significantly shorter than that in the Gemeprost group (19.5 h). The percentage of women who achieved successful abortion within 24 h in the misoprostol group (80.0%) was significantly higher than that in the Gemeprost group (58.6%). There was no significant difference in the incidence of side effects between the two groups except for diarrhea, which was more common in the Gemeprost group. The incidence of fever was more common in the misoprostol group. It is concluded that vaginal misoprostol is more effective than Gemeprost in termination of second trimester pregnancy.

  • Termination of second trimester pregnancy with Gemeprost and misoprostol: A randomized double-blind placebo-controlled trial
    'Elsevier BV', 1996
    Co-Authors: Tang Lch, Ngai Csw, Ks Chan, Ks Wong
    Abstract:

    A prospective randomized double-blind placebo-controlled trial was conducted in 70 subjects to determine whether pre-treatment with misoprostol could facilitate termination of second trimester pregnancy by Gemeprost. The women received either 400 μg oral misoprostol or placebo tablets 12 hours before the administration of vaginal pessary of Gemeprost 1 mg every 3 hours. There were no significant differences in induction-abortion interval and the amount of Gemeprost required between the misoprostol and the placebo group. There was no significant difference in the incidence of side effects or analgesic requirement between the two groups. We conclude that oral misoprostol is not useful in facilitating termination of second trimester pregnancy by Gemeprost. | In Hong Kong, 70 healthy women aged 16-40 years at the gestational age of 14-20 weeks who requested legal termination of pregnancy were randomly allocated to receive either 400 mg misoprostol or a placebo (vitamin B6) 12 hours before initial administration of intravaginal Gemeprost pessary (1 mg) every three hours. This double-blind study aimed to determine whether pretreatment with oral misoprostol can improve the efficacy of intravaginal Gemeprost pessary to effect induced abortion. The two groups responded essentially the same in terms of the incidence of nausea, vomiting, dizziness, fatigue, breast tenderness, or lower abdominal pain during the interval between misoprostol administration and Gemeprost administration. Similarly, side effects and analgesic requirements did not differ significantly. The complete abortion rate was not significantly different between the two groups (62.9% for misoprostol and 68.6% for placebo). Even though the induction-abortion interval was shorter and the amount of Gemeprost required was smaller in the misoprostol group than the placebo group (27.3 vs. 28.2 hours and 4.9 vs. 5.7 mg, respectively), the differences were not significant (p = 0.0863 and 0.0957, respectively). These findings suggest that oral misoprostol does not facilitate termination of second trimester pregnancy by intravaginal Gemeprost pessary.link_to_subscribed_fulltex

  • Termination of second trimester pregnancy with Gemeprost and misoprostol: a randomized double-blind placebo-controlled trial.
    Contraception, 1996
    Co-Authors: Ks Wong, Ks Chan, C.s.w. Ngai, Lawrence C. H. Tang
    Abstract:

    A prospective randomized double-blind placebo-controlled trial was conducted in 70 subjects to determine whether pre-treatment with misoprostol could facilitate termination of second trimester pregnancy by Gemeprost. The women received either 400 μg oral misoprostol or placebo tablets 12 hours before the administration of vaginal pessary of Gemeprost 1 mg every 3 hours. There were no significant differences in induction-abortion interval and the amount of Gemeprost required between the misoprostol and the placebo group. There was no significant difference in the incidence of side effects or analgesic requirement between the two groups. We conclude that oral misoprostol is not useful in facilitating termination of second trimester pregnancy by Gemeprost.