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Related Experiment Videos

Medical abortion in the second trimester.

Oi Shan Tang1, Pak Chung Ho

  • 1Department of Obstetrics and Gynaecology, The University of Hong Kong, China.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|June 4, 2002
PubMed
Summary

Second trimester abortion management has advanced with prostaglandin analogues and mifepristone. Combining these significantly improves outcomes, while analogue-only regimens offer an alternative when mifepristone is unavailable.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine

Background:

  • Second trimester abortion management has evolved significantly over the past two decades.
  • Prostaglandin analogues and mifepristone are key agents in modern protocols.

Purpose of the Study:

  • To review the efficacy and outcomes of prostaglandin analogue and mifepristone regimens for second trimester abortion.
  • To evaluate prostaglandin analogue-only regimens as an alternative when mifepristone is inaccessible.

Main Methods:

  • Systematic review of studies on gemeprost and misoprostol in combination with mifepristone.
  • Analysis of data for prostaglandin analogue-only regimens for second trimester termination.

Main Results:

  • Combination therapy (gemeprost or misoprostol with mifepristone) achieves >90% abortion rates within 24 hours, with a mean induction-abortion interval of ~6 hours.
  • Prostaglandin analogue-only regimens demonstrate >90% efficacy within 48 hours but have a longer mean induction-abortion interval of ~15 hours.
  • Intra-cervical tents can be utilized to reduce the induction-abortion interval in prostaglandin analogue-only regimens.

Conclusions:

  • Combined mifepristone and prostaglandin analogue therapy is highly effective for second trimester abortion.
  • Prostaglandin analogue-only regimens provide a viable, effective alternative, particularly in resource-limited settings.
  • Further research into methods like intra-cervical tents may optimize analogue-only protocols.

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