Reducing the induction to abortion interval in termination of second trimester pregnancies: a comparison of mifepristone with laminaria tent.

OBJECTIVE

To determine whether mifepristone (RU486) is more effective than laminaria tent in shortening the induction-abortion interval in termination of second trimester pregnancies with gemeprost.

DESIGN

Prospective randomised comparative trial.

SETTING

Department of Obstetrics and Gynaecology in a University teaching hospital.

SUBJECTS

Sixty-two women undergoing termination of pregnancy in the second trimester.

INTERVENTIONS

The women were allocated at random to one of the two treatment groups. The first group received 600 mg of mifepristone 36 h before administration of gemeprost. In the second group, a medium-sized laminaria tent was inserted 12 h before gemeprost. The pregnancies in both groups were terminated with vaginal gemeprost, 1 mg every 3 h up to a maximum of 5 mg/day.

MAIN OUTCOME MEASURES

Induction-abortion intervals, amount of gemeprost required, and incidence of side effects.

RESULTS

The median induction-abortion interval in the mifepristone group (7.5 h) was significantly shorter than that in the laminaria tent group (11 h) and significantly fewer gemeprost pessaries were required. There was no significant difference in the amount of narcotic analgesics required or the incidence of side effects between the two groups.

CONCLUSIONS

Mifepristone is more effective than laminaria tent in shortening the induction-abortion interval in termination of second trimester pregnancies.