Swahn M L, Ugocsai G, Bygdeman M, Kovacs L, Belsey E M, Van Look P F
Department of Obstetrics and Gynaecology, Karolinska Hospital, Stockholm, Sweden.
Hum Reprod. 1989 Jan;4(1):21-8. doi: 10.1093/oxfordjournals.humrep.a136838.
It has been shown that the antiprogestin RU 486 (mifepristone) increases the sensitivity of the early pregnant human uterus to the stimulatory action of synthetic prostaglandin E (PGE) analogues. To examine if RU 486 also increases uterine sensitivity to the naturally occurring PGE2 given orally, two investigative approaches were used in the present studies: (i) direct registration of uterine contractions before and after PGE2 administration in untreated and RU 486-treated early pregnant women; and (ii) a double-blind, randomized, controlled efficacy trial involving treatment of pregnant women (amenorrhoea of less than or equal to 49 days) with RU 486 (25 mg twice daily for 4 days) and PGE2 (1 mg once or twice) or placebo on the last day of RU 486 treatment. The results indicate that oral PGE2 at the doses employed had little or no stimulatory effect on uterine contractility and that it did not improve the rate of complete abortion achieved with RU 486 alone. Overall, 25 of 42 women (59%) had a complete abortion, 15 women (36%) did not abort and the remaining two had incomplete abortions. Women with complete abortions had significantly lower pretreatment levels of progesterone and a longer duration of induced bleeding than those who did not abort. Thus oral PGE2, when given in clinically acceptable doses, is not a suitable alternative to synthetic PGE analogues for use in combination with RU 486 for termination of early pregnancy.
业已表明，抗孕激素RU 486（米非司酮）可增强妊娠早期人子宫对合成前列腺素E（PGE）类似物刺激作用的敏感性。为了研究RU 486是否也能增强子宫对口服天然PGE2的敏感性，本研究采用了两种研究方法：（i）在未治疗和经RU 486治疗的妊娠早期妇女中，直接记录给予PGE2前后的子宫收缩情况；（ii）一项双盲、随机、对照疗效试验，在RU 486治疗的最后一天，对妊娠妇女（闭经小于或等于49天）用RU 486（25毫克，每日两次，共4天）和PGE2（1毫克，一次或两次）或安慰剂进行治疗。结果表明，所用剂量的口服PGE2对子宫收缩性几乎没有或没有刺激作用，并且它不能提高单独使用RU 486时的完全流产率。总体而言，42名妇女中有25名（59%）完全流产，15名妇女（36%）未流产，其余两名流产不完全。完全流产的妇女孕酮的预处理水平明显较低，诱导出血的持续时间比未流产的妇女长。因此，当以临床可接受的剂量给予时，口服PGE2不是与RU 486联合用于终止早期妊娠的合成PGE类似物的合适替代品。
