The Experts below are selected from a list of 24366 Experts worldwide ranked by ideXlab platform
Linan Cheng - One of the best experts on this subject based on the ideXlab platform.
-
termination of Second Trimester Pregnancy by mifepristone combined with misoprostol versus intra amniotic injection of ethacridine lactate rivanol a systematic review of chinese trials
Contraception, 2011Co-Authors: Aihua Fang, Qinfang Chen, Yongmei Huang, Oiuju Chen, Linan ChengAbstract:Abstract Background Mifepristone combined with misoprostol for Second-Trimester abortion (MM) and intra-amniotic injection of ethacridine lactate (EL; Rivanol®) are the common methods for termination of Second-Trimester Pregnancy in China. The systematic review of relevant literature was conducted to evaluate the effectiveness and safety on termination of Second-Trimester Pregnancy using MM, introduced in 1988 in China, versus the Chinese routinely used method since 1970 — EL. The review was conducted to evaluate mifepristone combined with the misoprostol versus intra-amniotic injection of ethacridine lactate in China for termination of Second-Trimester Pregnancy with respect to efficacy, side effects, complications and so on. Study Design The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, POPLINE, TOXLINE, World Health Organization–Department of Reproductive Health and Research, Chinese Biomedical Literature Database, Chinese Journal Full-text Database and Chinese Science & Technology Journal Database were systematically searched. Reference lists for English and Chinese-language reports (published from 1966 to 2008) were searched. All randomized controlled trials (RCTs) on Second-Trimester abortion by combination of mifepristone and misoprostol versus ethacridine lactate, which conducted in China, were analyzed. Trial quality was assessed, and data extraction was made independently by two reviewers. Results Fifteen original RCTs using MM versus EL were included. Three trials used oral misoprostol, six trials used vaginal misoprostol, and six trials used oral plus vaginal misoprostol. Failure rate of abortion was 2.0% to 5.9% in the MM group and 7.4% to 20.7% in the EL group. The incidence of postabortion curettage was similar in the two groups. The time of labor and hospitalization for abortion in the MM group were shorter compared with EL group. The blood loss within 2 h of abortion in the MM group was significantly less than that in the EL group, but the blood loss within 24 h of abortion was the same in both groups. More gastrointestinal side effects occurred with the MM regimen, whereas cervical injury occurred more often in the EL group. Conclusions Compared with the intra-amniotic injection of ethacridine lactate, mifepristone/misoprostol has a higher success rate and shorter time of labor with more gastrointestinal side effects for termination of Second-Trimester Pregnancy.
-
mifepristone combined with misoprostol versus intra amniotic injection of ethacridine lactate for the termination of Second Trimester Pregnancy a prospective open label randomized clinical trial
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010Co-Authors: Qinfang Chen, Aihua Fang, Lanrong Zhang, Linan ChengAbstract:Abstract Objectives To compare the effectiveness and safety of mifepristone/misoprostol versus intra-amniotic injection of ethacridine lactate for the termination of Second Trimester Pregnancy. Study design 210 women requesting voluntary termination of pregnancies at between 16 and 24 weeks of gestation were randomly assigned into two groups. Group 1 (MM) received a single oral dose of 200 mg mifepristone and, 36–48 h later, 400 μg of misoprostol vaginally, with up to three additional oral doses of 400 μg misoprostol every 12 h. Group 2 (EL) received an intra-amniotic injection of 100 mg ethacridine lactate. The primary outcome was successful abortion rate. Secondary outcomes included the difference in the induction-to-abortion interval and the frequency of adverse events. Results Both MM and EL regimens were effective, with successful abortion rates of 96.19% and 94.29%, respectively ( P = 0.746). The complete abortion rates were 68.57% and 70.48%, respectively. The induction-to-abortion interval was longer in the MM group than in the EL group (50.57 ± 6.80 h vs. 43.02 ± 8.74 h, respectively, P Conclusions Both MM and EL regimens were effective with high success rates and were safe for the termination of Second Trimester Pregnancy.
Jan E Dickinson - One of the best experts on this subject based on the ideXlab platform.
-
misoprostol for Second Trimester Pregnancy termination in women with a prior cesarean delivery
Obstetrics & Gynecology, 2005Co-Authors: Jan E DickinsonAbstract:OBJECTIVE:To evaluate the use of misoprostol in Second-Trimester abortion in women with prior cesarean deliveries.METHODS:A review of women with prior cesarean deliveries undergoing abortion at 14–28 weeks of gestation for a fetal anomaly over a 7.5-year period. Outcome data were compared with a con
-
a comparison of oral misoprostol with vaginal misoprostol administration in Second Trimester Pregnancy termination for fetal abnormality
Obstetrics & Gynecology, 2003Co-Authors: Jan E Dickinson, Sharon F EvansAbstract:Abstract Objective To compare the clinical efficacy and side effects of oral misoprostol with vaginal misoprostol for Second-Trimester Pregnancy termination. Methods A randomized clinical trial of medical Pregnancy termination between 14 and 26 weeks’ gestation was conducted. Three misoprostol regimens were compared: 400 μg vaginally at 6-hour intervals (group 1), 400 μg orally at 3-hour intervals (group 2), and a loading dose of 600 μg vaginally followed by 200 μg orally at 3-hour intervals (group 3). A sample size of 225 women was required for equivalence of the three regimens, with an interim safety analysis planned at 80 women. Results A significant difference between the groups was evident at the interim safety analysis and the study ceased. The subset of 84 women recruited before the study closure is described. There was a significant difference in the median time to achieve delivery among the three groups: group 1, 14.5 hours (95% confidence interval 12.0, 16.9), versus group 2, 25.5 hours (13.5, 23.8), versus group 3, 16.4 hours (interquartile range 14.2–37.3) ( P = .042). Within 24 hours of commencement 85.7% of women in group 1, 44.8% in group 2, and 74.1% in group 3 delivered ( P = .003). At 48 hours 0% in group 1, 20.7% in group 2, and 3.7% in group 3 were undelivered ( P = .011). There was no difference in women’s perceptions of the termination process. Conclusion In Second-Trimester Pregnancy termination, a vaginal misoprostol regimen of 400 μg every 6 hours was 1.9 times more likely to result in delivery within 24 hours from commencement than an oral regimen of 400 μg every 3 hours.
-
the optimization of intravaginal misoprostol dosing schedules in Second Trimester Pregnancy termination
American Journal of Obstetrics and Gynecology, 2002Co-Authors: Jan E Dickinson, Sharon F EvansAbstract:Abstract OBJECTIVE: The purpose of this study was to compare the clinical efficacy and side effects of 3 doses of intravaginal misoprostol for Second-Trimester Pregnancy termination. STUDY DESIGN: This was a prospective randomized, double-blind controlled clinical trial of 150 women who underwent Pregnancy termination between 14 and 30 weeks of gestation. Three intravaginal misoprostol regimens were compared: 200 μg misoprostol at 6-hour intervals (group 1), 400 μg misoprostol at 6-hour intervals (group 2), and a loading dose of 600 μg misoprostol followed by 200 μg at 6-hour intervals (group 3). RESULTS: There was a significant difference in the median time to achieve delivery among the 3 groups: group 1 (18.2 hours [IQ, 13.3-32.5 hours]) vs group 2 (15.1 hours [IQ, 10.9-23.7 hours]) vs group 3 (13.2 hours [IQ, 11.2-21.7 hours]; P =.035). Fifty-nine percent of the women in group 1, 76% of the women in group 2, and 80% of the women in group 3 delivered within 24 hours ( P =.013). There were 7.8% of the women in group 1, 0% of the women in group 2, and 2% of the women in group 3 who were undelivered at 48 hours ( P =.02). There was an increase in the incidence of fever in the first 12 hours ( P =.038) and in the incidence of vomiting within 3 hours of the initial dose ( P =.048) in group 3 compared with the other groups. CONCLUSION: Intravaginal misoprostol 400 μg at 6-hour intervals appears to be the preferred regimen for Second-Trimester Pregnancy termination, with a shorter commencement to delivery interval than the 200 μg regimen and fewer maternal side-effects than the 600 μg loading dose regimen. (Am J Obstet Gynecol 2002;186:470-4.)
Aihua Fang - One of the best experts on this subject based on the ideXlab platform.
-
termination of Second Trimester Pregnancy by mifepristone combined with misoprostol versus intra amniotic injection of ethacridine lactate rivanol a systematic review of chinese trials
Contraception, 2011Co-Authors: Aihua Fang, Qinfang Chen, Yongmei Huang, Oiuju Chen, Linan ChengAbstract:Abstract Background Mifepristone combined with misoprostol for Second-Trimester abortion (MM) and intra-amniotic injection of ethacridine lactate (EL; Rivanol®) are the common methods for termination of Second-Trimester Pregnancy in China. The systematic review of relevant literature was conducted to evaluate the effectiveness and safety on termination of Second-Trimester Pregnancy using MM, introduced in 1988 in China, versus the Chinese routinely used method since 1970 — EL. The review was conducted to evaluate mifepristone combined with the misoprostol versus intra-amniotic injection of ethacridine lactate in China for termination of Second-Trimester Pregnancy with respect to efficacy, side effects, complications and so on. Study Design The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, POPLINE, TOXLINE, World Health Organization–Department of Reproductive Health and Research, Chinese Biomedical Literature Database, Chinese Journal Full-text Database and Chinese Science & Technology Journal Database were systematically searched. Reference lists for English and Chinese-language reports (published from 1966 to 2008) were searched. All randomized controlled trials (RCTs) on Second-Trimester abortion by combination of mifepristone and misoprostol versus ethacridine lactate, which conducted in China, were analyzed. Trial quality was assessed, and data extraction was made independently by two reviewers. Results Fifteen original RCTs using MM versus EL were included. Three trials used oral misoprostol, six trials used vaginal misoprostol, and six trials used oral plus vaginal misoprostol. Failure rate of abortion was 2.0% to 5.9% in the MM group and 7.4% to 20.7% in the EL group. The incidence of postabortion curettage was similar in the two groups. The time of labor and hospitalization for abortion in the MM group were shorter compared with EL group. The blood loss within 2 h of abortion in the MM group was significantly less than that in the EL group, but the blood loss within 24 h of abortion was the same in both groups. More gastrointestinal side effects occurred with the MM regimen, whereas cervical injury occurred more often in the EL group. Conclusions Compared with the intra-amniotic injection of ethacridine lactate, mifepristone/misoprostol has a higher success rate and shorter time of labor with more gastrointestinal side effects for termination of Second-Trimester Pregnancy.
-
mifepristone combined with misoprostol versus intra amniotic injection of ethacridine lactate for the termination of Second Trimester Pregnancy a prospective open label randomized clinical trial
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2010Co-Authors: Qinfang Chen, Aihua Fang, Lanrong Zhang, Linan ChengAbstract:Abstract Objectives To compare the effectiveness and safety of mifepristone/misoprostol versus intra-amniotic injection of ethacridine lactate for the termination of Second Trimester Pregnancy. Study design 210 women requesting voluntary termination of pregnancies at between 16 and 24 weeks of gestation were randomly assigned into two groups. Group 1 (MM) received a single oral dose of 200 mg mifepristone and, 36–48 h later, 400 μg of misoprostol vaginally, with up to three additional oral doses of 400 μg misoprostol every 12 h. Group 2 (EL) received an intra-amniotic injection of 100 mg ethacridine lactate. The primary outcome was successful abortion rate. Secondary outcomes included the difference in the induction-to-abortion interval and the frequency of adverse events. Results Both MM and EL regimens were effective, with successful abortion rates of 96.19% and 94.29%, respectively ( P = 0.746). The complete abortion rates were 68.57% and 70.48%, respectively. The induction-to-abortion interval was longer in the MM group than in the EL group (50.57 ± 6.80 h vs. 43.02 ± 8.74 h, respectively, P Conclusions Both MM and EL regimens were effective with high success rates and were safe for the termination of Second Trimester Pregnancy.
Daniel R Mishell - One of the best experts on this subject based on the ideXlab platform.
-
a comparison of two dosing regimens of intravaginal misoprostol for Second Trimester Pregnancy termination
Obstetrics & Gynecology, 1999Co-Authors: John K Jain, John S Kuo, Daniel R MishellAbstract:Abstract Objective: To compare the effectiveness of misoprostol administered intravaginally every 6 versus every 12 hours for termination of Second-Trimester pregnancies. Methods: One hundred pregnant women at 12–22 weeks’ gestation were randomized to receive 200 μg of misoprostol intravaginally either every 6 or every 12 hours for up to 48 hours. Results: The incidences of abortion within 48 hours after initial drug administration were 87.2 and 89.2%, the complete abortion rates 43.9 and 33.3%, and the mean abortion intervals 13.8 and 14.0 hours in the 6- and 12-hour groups, respectively. Side effects were similar between groups. Conclusion: Misoprostol administered vaginally is effective for terminating Second-Trimester pregnancies. Shortening the dosing interval from 12 to 6 hours produced no significant benefit.
-
a comparison of intravaginal misoprostol with prostaglandin e2 for termination of Second Trimester Pregnancy
The New England Journal of Medicine, 1994Co-Authors: John K Jain, Daniel R MishellAbstract:Background The most widely used medical method of terminating Second-Trimester Pregnancy is the intravaginal administration of prostaglandin E2 (dinoprostone [PGE2]). This treatment is highly effective but is associated with severe gastrointestinal side effects and hyperpyrexia. Methods We conducted a prospective, randomized trial comparing the efficacy and safety of misoprostol, a prostaglandin E1 analogue (200 μg intravaginally every 12 hours), with the efficacy and safety of PGE2 (20 mg intravaginally every 3 hours). The study population included 55 pregnant women between 12 and 22 weeks' gestation who were undergoing termination of Pregnancy for either intrauterine fetal death (37 women) or medical or genetic reasons (18 women). Results The rate of successful abortions within 24 hours was 81 percent (22 of 27 women) with PGE2 and 89 percent (25 of 28 women) with misoprostol (P = 0.47). All the women who received misoprostol had successful abortions within 38 hours. Among those who had an abortion with...
Sharon F Evans - One of the best experts on this subject based on the ideXlab platform.
-
a comparison of oral misoprostol with vaginal misoprostol administration in Second Trimester Pregnancy termination for fetal abnormality
Obstetrics & Gynecology, 2003Co-Authors: Jan E Dickinson, Sharon F EvansAbstract:Abstract Objective To compare the clinical efficacy and side effects of oral misoprostol with vaginal misoprostol for Second-Trimester Pregnancy termination. Methods A randomized clinical trial of medical Pregnancy termination between 14 and 26 weeks’ gestation was conducted. Three misoprostol regimens were compared: 400 μg vaginally at 6-hour intervals (group 1), 400 μg orally at 3-hour intervals (group 2), and a loading dose of 600 μg vaginally followed by 200 μg orally at 3-hour intervals (group 3). A sample size of 225 women was required for equivalence of the three regimens, with an interim safety analysis planned at 80 women. Results A significant difference between the groups was evident at the interim safety analysis and the study ceased. The subset of 84 women recruited before the study closure is described. There was a significant difference in the median time to achieve delivery among the three groups: group 1, 14.5 hours (95% confidence interval 12.0, 16.9), versus group 2, 25.5 hours (13.5, 23.8), versus group 3, 16.4 hours (interquartile range 14.2–37.3) ( P = .042). Within 24 hours of commencement 85.7% of women in group 1, 44.8% in group 2, and 74.1% in group 3 delivered ( P = .003). At 48 hours 0% in group 1, 20.7% in group 2, and 3.7% in group 3 were undelivered ( P = .011). There was no difference in women’s perceptions of the termination process. Conclusion In Second-Trimester Pregnancy termination, a vaginal misoprostol regimen of 400 μg every 6 hours was 1.9 times more likely to result in delivery within 24 hours from commencement than an oral regimen of 400 μg every 3 hours.
-
the optimization of intravaginal misoprostol dosing schedules in Second Trimester Pregnancy termination
American Journal of Obstetrics and Gynecology, 2002Co-Authors: Jan E Dickinson, Sharon F EvansAbstract:Abstract OBJECTIVE: The purpose of this study was to compare the clinical efficacy and side effects of 3 doses of intravaginal misoprostol for Second-Trimester Pregnancy termination. STUDY DESIGN: This was a prospective randomized, double-blind controlled clinical trial of 150 women who underwent Pregnancy termination between 14 and 30 weeks of gestation. Three intravaginal misoprostol regimens were compared: 200 μg misoprostol at 6-hour intervals (group 1), 400 μg misoprostol at 6-hour intervals (group 2), and a loading dose of 600 μg misoprostol followed by 200 μg at 6-hour intervals (group 3). RESULTS: There was a significant difference in the median time to achieve delivery among the 3 groups: group 1 (18.2 hours [IQ, 13.3-32.5 hours]) vs group 2 (15.1 hours [IQ, 10.9-23.7 hours]) vs group 3 (13.2 hours [IQ, 11.2-21.7 hours]; P =.035). Fifty-nine percent of the women in group 1, 76% of the women in group 2, and 80% of the women in group 3 delivered within 24 hours ( P =.013). There were 7.8% of the women in group 1, 0% of the women in group 2, and 2% of the women in group 3 who were undelivered at 48 hours ( P =.02). There was an increase in the incidence of fever in the first 12 hours ( P =.038) and in the incidence of vomiting within 3 hours of the initial dose ( P =.048) in group 3 compared with the other groups. CONCLUSION: Intravaginal misoprostol 400 μg at 6-hour intervals appears to be the preferred regimen for Second-Trimester Pregnancy termination, with a shorter commencement to delivery interval than the 200 μg regimen and fewer maternal side-effects than the 600 μg loading dose regimen. (Am J Obstet Gynecol 2002;186:470-4.)