[Clinical study of terminating biochemical pregnancy and early clinical pregnancy with mifepristone and misoprostol]

Abstract

Objective: To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol.

Methods: Mifepristone (150 mg) combined with misoprostol (600 microg) 3 days later were given to 500 biochemical pregnancies (G(1)), 500 early clinical pregnancies (G(2)) and 500 clinical pregnancies (G(3)) which were classified according to amenorrhea days, serum human chorionic gonadotropin-beta subunit (beta-hCG) and vaginal B-ultrasonic examinations. All were observed for 6 hours after taking misoprostol and returned for assessment per week.

Results: Expulsion of conceptus was G(1) 123 (24.6%, 123/500), G(2) 438 (87.6%, 438/500) and G(3) 467 (93.4%, 467/500). Failure rate was G(1) 6 (1.2%, 6/500), G(2) 24 (4.8%, 24/500) and G(3) 79 (15.8%, 79/500) for ongoing pregnancies, hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding. Bleeding cases during the administration of mifepristone were G(1) 272 (54.4%, 272/500), G(2) 141 (28.2%, 141/500) and G(3) 87 (17.4%, 87/500); the mean bleeding days were G(1) (5.8 +/- 1.5), G(2) (9.0 +/- 2.9) and G(3) (14.3 +/- 5.9) days. Other side effects including abdominal pain, nausea, vomiting and diarrhea were low and light in each group, increasing with advancing gestational age. Menses recovery was 486 (97.2%, 486/500), 452 (90.4%, 452/500) and 433 (86.6%, 433/500) for each group on scheduled time. Satisfaction was 499 (99.8%, 499/500), 485 (97.0%, 485/500) and 369 (73.8%, 369/500) respectively.

Conclusion: Mifepristone and misoprostol in combination is as safe, and effective for termination of biochemical pregnancies as ordinary medical abortion. It does not need to wait till ectopic pregnancy is excluded.