Linked Life Data

10745067

Source:http://linkedlifedata.com/resource/pubmed/id/10745067

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2000-5-11
pubmed:abstractText
Multiple clinical studies demonstrate the efficacy of medical abortion with mifepristone or methotrexate followed by a prostaglandin analogue. However, assessing predictors of success, including regimen, is difficult because of regimen variability and a lack of direct comparisons. This meta-analysis estimates rates of primary clinical outcomes of medical abortion (successful abortion, incomplete abortion, and viable pregnancy) and compares them by regimen and gestational age. We identified 54 studies published from 1991 to 1998 using mifepristone with misoprostol (18), mifepristone with other prostaglandin analogues (23), and methotrexate with misoprostol (13). Data abstracted from studies included regimen details and clinical outcomes by gestational age. We found that efficacy decreases with increasing gestational age (p<0.001), and differences by regimen are not statistically significant except at gestational age > or =57 days. For gestations < or =49 days, mean rates of complete abortion were 94-96%, incomplete abortion 2-4%, and ongoing (viable) pregnancy 1-3%. For gestations of 50-56 days, the mean rate of complete abortion was 91% (same for all regimens), incomplete abortion 5-8%, and ongoing pregnancy 3-5%. For > or =57 days, success was lower for mifepristone/misoprostol (85%, 95% confidence interval 78-91%) than for mifepristone/other prostaglandin analogues 95% (CI 91-98%, p = 0.006). For mifepristone/misoprostol, using > or =2 prostaglandin analogue doses seems to be better than a single dose for certain outcomes and gestational ages. We conclude that both mifepristone and methotrexate, when administered with misoprostol, have high levels of success at < or =49 days gestation but may have lower efficacy at longer gestation.
pubmed:keyword
http://linkedlifedata.com/resource/pubmed/keyword/Abortion, Drug Induced, http://linkedlifedata.com/resource/pubmed/keyword/Abortion, Incomplete, http://linkedlifedata.com/resource/pubmed/keyword/Abortion, Induced, http://linkedlifedata.com/resource/pubmed/keyword/Biology, http://linkedlifedata.com/resource/pubmed/keyword/DRUGS, http://linkedlifedata.com/resource/pubmed/keyword/Endocrine System, http://linkedlifedata.com/resource/pubmed/keyword/Family Planning, http://linkedlifedata.com/resource/pubmed/keyword/Fertility Control, Postconception, http://linkedlifedata.com/resource/pubmed/keyword/Hormone Antagonists, http://linkedlifedata.com/resource/pubmed/keyword/Hormones, http://linkedlifedata.com/resource/pubmed/keyword/Literature Review, http://linkedlifedata.com/resource/pubmed/keyword/METHOTREXATE, http://linkedlifedata.com/resource/pubmed/keyword/Physiology, http://linkedlifedata.com/resource/pubmed/keyword/Ru-486, http://linkedlifedata.com/resource/pubmed/keyword/Treatment
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0010-7824
pubmed:author
pubmed:issnType
Print
pubmed:volume
61
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
29-40
pubmed:dateRevised
2006-11-15
pubmed:otherAbstract
PIP: Multiple clinical studies demonstrate the efficacy of medical abortion with mifepristone or methotrexate followed by a prostaglandin analogue. However, assessing predictors of success, including regimen, is difficult because of regimen variability and a lack of direct comparisons. This meta-analysis estimates rates of primary clinical outcomes of medical abortion (successful abortion, incomplete abortion, and viable pregnancy) and compares them by regimen and gestational age. The authors identified 54 studies published from 1991 to 1998 using mifepristone with misoprostol (18), mifepristone with other prostaglandin analogues (23), and methotrexate with misoprostol (13). Data abstracted from studies included regimen details and clinical outcomes by gestational age. The authors found that efficacy decreases with increasing gestational age (p 0.001), and differences by regimen are not statistically significant except at gestational age 57 days or more. For gestations of 49 or fewer days, mean rates of complete abortion were 94-96%, incomplete abortion 2-4%, and ongoing (viable) pregnancy 1-3%. For gestations of 50-56 days, the mean rate of complete abortion was 91% (same for all regimens), incomplete abortion 5-8%, and ongoing pregnancy 3-5%. For 57 days or more, success was lower for mifepristone/misoprostol (85%; 95% CI, 78-91%) than for mifepristone/other prostaglandin analogues (95%; 95% CI, 91-98%; p = 0.006). For mifepristone/misoprostol, using 2 or more prostaglandin analogue doses seems to be better than a single dose for certain outcomes and gestational ages. The authors conclude that both mifepristone and methotrexate, when administered with misoprostol, have high levels of success at 49 or fewer days.
pubmed:meshHeading
pubmed:year
2000
pubmed:articleTitle
The efficacy of medical abortion: a meta-analysis.
pubmed:affiliation
Institute for Health Policy Studies and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA. jgkahn@itsa.ucsf.edu
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Meta-Analysis