Schaff E A, Stadalius L S, Eisinger S H, Franks P
Department of Family Medicine, University of Rochester, NY 14620, USA.
J Fam Pract. 1997 Apr;44(4):353-60.
There have been no US studies published on the effectiveness, safety, time to bleeding, and acceptability of misoprostol administered by vagina at home and repeated, if needed, after mifepristone was administered for abortion in women up to 8 weeks pregnant.
A prospective trial was conducted with women up to 8 weeks pregnant wanting an abortion. After receiving mifepristone 600 mg orally, subjects self-administered vaginal misoprostol 800 micrograms at home 2 days later. Subjects returned within 7 days, and if the gestational sac was still present on ultrasound, a repeat dose of misoprostol was administered in the office. Subjects completed a daily symptom log and a questionnaire on the acceptability of the procedures.
Of the 166 subjects, 163 (98%) had a complete medical abortion. Three subjects presented with persistent bleeding and an incomplete abortion from 27 to 35 days after taking mifepristone and required surgical intervention. Vaginal spotting or bleeding occurred in 104 (62%) subjects before taking misoprostol, and 18 (11%) did not use misoprostol. Bleeding occurred on average 3.5 hours (SD, 3.2) after taking misoprostol. Six (4%) subjects required a second dose of misoprostol. Gastrointestinal side effects were common, mild, and brief. One hundred fifty-nine (96%) subjects agreed that the procedure went well, and 146 (90%) agreed that home administration of misoprostol was acceptable.
Two days after taking mifepristone, misoprostol administered by vagina was found to be safe, highly effective, and acceptable to women. Since only 6 subjects needed a second dose of misoprostol, conclusions about repeat doses are not possible. This procedure is a promising alternative to surgical abortion.
在美国，尚未有关于在家自行经阴道给予米索前列醇用于怀孕8周以内妇女流产的有效性、安全性、出血时间以及可接受性的研究发表，且在服用米非司酮后如有需要可重复给药。
对怀孕8周以内希望终止妊娠的妇女进行了一项前瞻性试验。口服600毫克米非司酮后，受试者于2天后在家自行经阴道给予800微克米索前列醇。受试者在7天内复诊，若超声检查仍见妊娠囊，则在诊室给予重复剂量的米索前列醇。受试者完成每日症状记录以及关于该操作可接受性的问卷调查。
166名受试者中，163名（98%）完成了药物流产。3名受试者在服用米非司酮后27至35天出现持续出血和不全流产，需要进行手术干预。104名（62%）受试者在服用米索前列醇前出现阴道点滴出血或出血，18名（11%）未使用米索前列醇。服用米索前列醇后平均3.5小时（标准差3.2）出现出血。6名（4%）受试者需要第二剂米索前列醇。胃肠道副作用常见、轻微且短暂。159名（96%）受试者认为该操作顺利，146名（90%）受试者认为在家自行给予米索前列醇是可以接受的。
服用米非司酮2天后，经阴道给予米索前列醇被发现是安全、高效且为女性所接受的。由于只有6名受试者需要第二剂米索前列醇，因此无法得出关于重复给药的结论。该方法是手术流产的一个有前景的替代方案。
