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https://www.readbyqxmd.com/read/28432086/comparing-two-regimens-of-in-travaginal-misoprostol-with-intravaginal-gemeprost-for-second-trimesterpregnancy-termination-a-randomised-controlled-trial
#1
Daniel Seow Choon Koh, Esther Pei Jing Ang, Jurja Chua Coyuco, Hua Zhen Teo, Xiaoling Huang, Xing Wei, Mor Jack Ng, Serene Liqing Lim, Kok Hian Tan
AIM: To compare the efficacy and safety of intravaginal misoprostol 200 µg, 400 µg and gemeprost regimens for second-trimester termination of pregnancy (TOP). METHODS: A three-armed randomised controlled trial (Clinical Trial Certificate 1100015) where 116 women undergoing second-trimester TOP were given intravaginal misoprostol 200 µg (n=37), misoprostol 400 µg (n=40) or gemeprost 1 mg (n=39) at 4-hour intervals until abortion occurred with a maximum of five doses...
April 21, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28421651/self-management-of-first-trimester-medical-termination-of-pregnancy-a-qualitative-study-of-women-s-experiences
#2
Carrie Purcell, Sharon Cameron, Julia Lawton, Anna Glasier, Jeni Harden
OBJECTIVE: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. DESIGN: Qualitative interview study. SETTING: One National Health Service health board (administrative) area in Scotland. POPULATION OR SAMPLE: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28409600/postpartum-hemorrhage-prevention-and-treatment
#3
Ann Evensen, Janice M Anderson, Patricia Fontaine
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration...
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28405116/oral-misoprostol-solution-for-induction-of-labour
#4
Varsha L Deshmukh, Apurva V Rajamanya, K A Yelikar
OBJECTIVE: To determine the effects of oral misoprostol solution for induction of labour. STUDY DESIGN: This is a prospective observational study. SETTING: This study was conducted in Government Medical College, Aurangabad. METHOD: Patients undergoing induction of labour after 36 weeks of pregnancy were allocated by randomization to induction of labour with oral misoprostol solution administered 2 h apart. Delivery within 24 h after induction with oral misoprostol solution was the primary outcome on which the sample size was based...
April 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28402415/single-versus-repeat-doses-of-misoprostol-for-treatment-of-early-pregnancy-loss-a-randomized-clinical-trial
#5
Yossi Mizrachi, Ann Dekalo, Ohad Gluck, Hadas Miremberg, Lotem Dafna, Ohad Feldstein, Eran Weiner, Jacob Bar, Ron Sagiv
STUDY QUESTION: Does repeat administration of misoprostol for early pregnancy loss increase the treatment success rate? SUMMARY ANSWER: Repeat administration of misoprostol does not increase the treatment success rate, and is associated with more analgesics use. WHAT IS KNOWN ALREADY: Misoprostol reduces the need for surgical evacuation and shortens the time to complete expulsion in patients with early pregnancy loss. However, the impact of repeat doses of misoprostol is not clear...
April 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28390604/protective-role-of-misoprostol-in-prevention-of-gentamicin-ototoxicity
#6
Murat Dogan, Halil Polat, Mehmet Yasar, Ali Bayram, Duran Karatas, İbrahim Hira, Ahmet Kale, Fatma Senel, İbrahim Özcan
OBJECTIVES: To demonstrate potential protective effect of misoprostol on cochlear toxicity caused by gentamicin with electrophysiological tests and histopathological studies. MATERIALS AND METHODS: The study included 80 ears of 40 rats with normal hearing threshold and DPOAE value in both ears. Animals were assigned into 4 groups. The rats were randomized into 4 groups. Group I (n = 10): Gentamicin, Group II (n = 10): Gentamicin plus misoprostol, Group III (n = 10): Saline; Group IV (n = 10): Misoprostol...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28384938/misoprostol-induced-convulsion-a-rare-side-effect-of-misoprostol
#7
Nalini Sharma, Rituparna Das, Santa Singh Ahanthem, Kalyani Reddy
Misoprostol, a synthetic prostaglandin E1 has wider application in obstetrics gynaecology. It has been recommended in the prophylaxis and treatment of Post Partum Haemorrhage (PPH) by Federation of Obstetrics and Gynaecology (FIGO), World Health Organisation (WHO) and American College of Obstetrics and Gynaecology (ACOG). It is a very safe drug associated with transient side-effects like fever, chills, nausea, vomiting, diarrhoea and abdominal pain. In the present case report patient had an unusual side effect of hyperpyrexia and convulsion after use of misoprostol for prophylaxis against PPH...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383770/cost-effectiveness-analysis-and-obstetrics-the-time-has-come
#8
Robert M Silver, Brett D Einerson
In this issue of BJOG, ten Eikelder and colleagues report that oral misoprostol and foley bulb catheters for cervical ripening have equal cost-effectiveness. If women receiving foley bulbs undergo ripening at home or on a less intensive unit than a labor and delivery suite, the foley bulb is considerably more cost-effective. They used data from a Dutch RCT, the PROBAAT2 trial, comparing the two methods, which had similar efficacy. The analysis has many strengths including using comparisons from within an RCT, careful assessment of measurable direct hospital costs, and the use of well-chosen sensitivity analyses to evaluate the assumptions under a wide variety of clinical scenarios...
April 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28378361/misoprostol-use-for-second-trimester-termination-of-pregnancy-among-women-with-one-or-more-previous-cesarean-deliveries
#9
Martin Cuellar Torriente, Wilhelm J Steinberg, Gina Joubert
OBJECTIVE: To establish the safety and efficacy of misoprostol for second-trimester termination of pregnancy among women with one or more previous cesarean deliveries. METHODS: In a retrospective study, data were reviewed from women attending a reproductive health clinic in Bloemfontein, South Africa, for second-trimester termination between 2010 and 2013. The study group, comprising women with one or more previous cesareans, was compared with a control group, comprising women with no previous cesarean or uterine scarring...
April 4, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28357885/community-based-misoprostol-for-the-prevention-of-post-partum-haemorrhage-a-narrative-review-of-the-evidence-base-challenges-and-scale-up
#10
Karen Hobday, Jennifer Hulme, Suzanne Belton, Caroline Se Homer, Ndola Prata
Achieving Sustainable Development Goal targets for 2030 will require persistent investment and creativity in improving access to quality health services, including skilled attendance at birth and access to emergency obstetric care. Community-based misoprostol has been extensively studied and recently endorsed by the WHO for the prevention of post-partum haemorrhage. There remains little consolidated information about experience with implementation and scale-up to date. This narrative review of the literature aimed to identify the political processes leading to WHO endorsement of misoprostol for the prevention of post-partum haemorrhage and describe ongoing challenges to the uptake and scale-up at both policy and community levels...
March 30, 2017: Global Public Health
https://www.readbyqxmd.com/read/28351055/comparison-of-the-induction-to-delivery-interval-in-terminations-of-pregnancy-with-or-without-dilapan-s%C3%A2
#11
Marie Vincienne, Olivia Anselem, Anne Gaelle Cordier, Camille Le Ray, Vassilis Tsatsaris, Alexandra Benachi, François Goffinet
OBJECTIVE: In France, terminations of pregnancy (TOP) for medical reasons beyond the second trimester use mifepristone and misoprostol. We sought to determine the effectiveness of Dilapan-S®, an osmotic cervical dilator, in shortening the induction-to-delivery interval (IDI). MATERIALS AND METHODS: This retrospective study of TOP in 2010-2012 compared the results from 2 hospitals with different TOP protocols starting at 16 weeks' gestation, one (164 women) with and one (106) without Dilapan-S®...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28345139/utility-of-%C3%AE-hcg-monitoring-in-the-follow-up-of-medical-management-of-miscarriage
#12
Scott G Petersen, Anneliese R Perkins, Kristen S Gibbons, Julia I Bertolone, Kassam Mahomed
OBJECTIVE: To evaluate the percentage change in total βeta-unit human chorionic gonadotropin (βhCG) levels (%ΔβhCG) in the prediction of treatment outcomes following intravaginal misoprostol for missed miscarriage before 13 weeks. METHODS: A secondary analysis of a randomised controlled study of medical management of miscarriage was performed. Total βhCG levels were collected before misoprostol (baseline) and after a planned seven day interval (follow-up), when a transvaginal ultrasound (TVUS) reported a gestational sac as present or not...
March 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28342186/simplifying-oral-misoprostol-protocols-for-the-induction-of-labour
#13
Andrew D Weeks, Kate Navaratnam, Zarko Alfirevic
Induction of labour is carried out worldwide for a broad range of maternal and fetal indications so as to improve pregnancy outcomes. Oral misoprostol has been widely discussed as a method of labour induction. It is recommended for this indication by the WHO, FIGO, and SOGC(1-3) . A systematic review comparing misoprostol with Foley catheter and dinoprostone induction agents suggests that "Oral misoprostol for the induction of labour is safer than vaginal misoprostol and has the lowest rate of caesarean section"...
March 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28330856/-my-friend-who-bought-it-for-me-she-has-had-an-abortion-before-the-influence-of-ghanaian-women-s-social-networks-in-determining-the-pathway-to-induced-abortion
#14
Sarah D Rominski, Jody R Lori, Emmanuel Sk Morhe
BACKGROUND: Even given the liberal abortion law in Ghana, abortion complications are a large contributor to maternal morbidity and mortality. This study sought to understand why young women seeking an abortion in a legally enabling environment chose to do this outside the formal healthcare system. METHODS: Women being treated for complications arising from a self-induced abortion as well as for elective abortions at three hospitals in Ghana were interviewed. Community-based focus groups were held with women as well as men, separately...
March 22, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28320031/can-the-induction-of-labor-with-misoprostol-increase-maternal-blood-loss
#15
Paulo César Praciano Souza, Karla Santana Azevedo Damasceno, Edward Araujo Júnior, Carlos Augusto Alencar Júnior, Francisco Edson de Lucena Feitosa
Purpose To evaluate blood loss during misoprostol-induced vaginal births and during cesarean sections after attempted misoprostol induction. Methods We conducted a prospective observational study in 101 pregnant women indicated for labor induction; pre- and postpartum hemoglobin levels were measured to estimate blood loss during delivery. Labor was induced by administering 25 µg vaginal misoprostol every 6 hours (with a maximum of 6 doses). The control group included 30 patients who spontaneously entered labor, and 30 patients who underwent elective cesarean section...
February 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28317327/a-research-agenda-for-moving-early-medical-pregnancy-termination-over-the-counter
#16
REVIEW
Nathalie Kapp, Daniel Grossman, Emily Jackson, Laura Castleman, Dalia Brahmi
Given the overall safety profile and increasing availability of medical pregnancy termination drugs, we asked: would the mifepristone-misoprostol regimen for medical termination at ≤10 weeks gestation meet U.S. FDA regulatory criteria for over-the-counter (OTC) approval, and if not, what are the present research gaps? We conducted a literature review of consumer behaviors necessary for a successful OTC application for medical termination ≤10 weeks and identified crucial research gaps. If we were to embark on a development program for OTC or more generally, self-use of medical termination, the critical elements missing are the label comprehension, self -selection and actual use studies...
March 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28303569/efficacy-and-safety-of-mifepristone-buccal-misoprostol-for-early-medical-abortion-in-an-australian-clinical-setting
#17
Philip Goldstone, Clara Walker, Katherine Hawtin
BACKGROUND: In 2014, a composite pack containing mifepristone-buccal misoprostol, indicated for use to 63 days gestation replaced the existing regimen for early medical abortion (EMA) in Australia. AIMS: To provide updated efficacy and safety information for the use of mifepristone-buccal misoprostol for EMA in Australia, and assess the effect of patient age and gestational age on efficacy. MATERIALS AND METHODS: Observational cohort study of 15 008 women attending one of 16 Marie Stopes International clinics in Australia for an EMA (gestational age ≤ 63 days) between 1 March 2013 and 30 September 2015...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28292361/effectiveness-of-per-rectal-misoprostol-versus-intramuscular-oxytocin-for-prevention-of-primary-postpartum-haemorrhage
#18
Raheela Asmat, Tasneem Ashraf, Fazila Asmat, Shakila Asmat, Nagina Asmat
OBJECTIVE: To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). STUDY DESIGN: Randomised controlled trial study. PLACE AND DURATION OF STUDY: Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. METHODOLOGY: Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28288649/medical-termination-of-pregnancy-in-general-practice-in-australia-a-descriptive-interpretive-qualitative-study
#19
Angela J Dawson, Rachel Nicolls, Deborah Bateson, Anna Doab, Jane Estoesta, Ann Brassil, Elizabeth A Sullivan
BACKGROUND: Australian Government approval in 2012 for the use of mifepristone and misoprostol for medical termination of pregnancy (MTOP) allows general practitioners (GPs) to provide early gestation abortion in primary care settings. However, uptake of the MTOP provision by GPs appears to be low and the reasons for this have been unclear. This study investigated the provision of and referral for MTOP by GPs. METHODS: We undertook descriptive-interpretive qualitative research and selected participants for diversity using a matrix...
March 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28282779/sequential-use-of-foley-catheter-with-misoprostol-for-second-trimester-pregnancy-termination-in-women-with-and-without-caesarean-scars-a-prospective-cohort-study
#20
Melih Velipasaoglu, Cem Yagmur Ozdemir, Burcu Ozek, Reyhan Ayaz, Huseyin Mete Tanir
PURPOSE: The aim of this study is to evaluate the effectiveness and safety of misoprostol and Foley catheter in second trimester termination in women with and without caesarean section (CS) scars. MATERIALS AND METHODS: Women with an indication for pregnancy termination between 14 and 22 completed weeks of gestation were included to the study. Enrolled women were allocated into three groups: (1) women with no history of CS, (2) women with one CS and (3) women with ≥2 CS...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
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