Choobun Thanapan, Maneeon Ronnarong
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J Obstet Gynaecol Res. 2023 Jan;49(1):103-108. doi: 10.1111/jog.15455. Epub 2022 Oct 2.
This study aimed to study serum beta-human chorionic gonadotropin level trends after medical abortion using mifepristone and misoprostol in the early first trimester.
We enrolled women at ≤63 days of gestation who were indicated for pregnancy termination. We excluded women with incomplete abortions, nonviable pregnancies, extrauterine pregnancies, and contraindications for mifepristone/misoprostol use. Women received oral mifepristone (200 mg), followed by vaginal misoprostol (800 mcg) after 48 h. Serum beta-human chorionic gonadotropin levels were monitored pre-mifepristone administration (day 1); 48 h post-mifepristone, pre-misoprostol administration (day 3); day 10; and weekly after day 10, until negative beta-human chorionic gonadotropin levels (<25 mIU/mL) were achieved.
Among 39 enrolled women, 36 (92.3%) who underwent complete abortion without further interventions were included. The median gestational age was 51 (32-61) days. Three phases of beta-human chorionic gonadotropin levels were observed: an increase of up to 5.1% within 48 h of taking mifepristone, before misoprostol administration; a rapid decline on day 10 (by 98.5% compared with initial levels); and a slow decline after day 10 until negative results were attained within 7 weeks.
Serum beta-human chorionic gonadotropin levels minimally increased 48 h after taking mifepristone, rapidly declined within 1 week of misoprostol administration, and slowly declined until negative within 7 weeks post-abortion.
本研究旨在探讨孕早期使用米非司酮和米索前列醇药物流产后血清β-人绒毛膜促性腺激素水平的变化趋势。
我们纳入了妊娠≤63天且有终止妊娠指征的女性。排除了流产不全、胚胎停育、异位妊娠以及有米非司酮/米索前列醇使用禁忌证的女性。女性口服米非司酮（200mg），48小时后阴道给予米索前列醇（800μg）。在服用米非司酮前（第1天）、服用米非司酮48小时后且服用米索前列醇前（第3天）、第10天以及第10天后每周监测血清β-人绒毛膜促性腺激素水平，直至β-人绒毛膜促性腺激素水平呈阴性（<25mIU/mL）。
39名纳入研究的女性中，36名（92.3%）完全流产且无需进一步干预。中位孕周为51（32 - 61）天。观察到β-人绒毛膜促性腺激素水平有三个阶段的变化：在服用米索前列醇前，服用米非司酮48小时内水平最高可升高5.1%；第10天迅速下降（与初始水平相比下降98.5%）；第10天后缓慢下降，直至7周内呈阴性。
服用米非司酮48小时后血清β-人绒毛膜促性腺激素水平轻微升高，服用米索前列醇1周内迅速下降，流产后7周内缓慢下降直至呈阴性。
