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Susmita Chatterjee, Anupam Sarkar, Krishna D Rao
BACKGROUND: Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH...
2016: PloS One
Laura R Matthews, Linda OʼDwyer, Erica OʼNeill
OBJECTIVE: To examine rates of intrauterine device (IUD) insertion failure with and without prior misoprostol administration. Additional outcomes included difficulty of insertion, subjective pain, expulsion, and complications. DATA SOURCES: Systematic searches were performed in PubMed MEDLINE, Cochrane Central Register of Controlled Trials,, and Cumulative Index to Nursing and Allied Health Literature for articles with the following keywords: "misoprostol," "intrauterine devices," and "IUDs...
October 6, 2016: Obstetrics and Gynecology
Dina Fatima Abbas, Jennifer Blum, Nguyen Thi Nhu Ngoc, Nguyen Thi Bach Nga, Huynh Thi Kim Chi, Roxanne Martin, Beverly Winikoff
OBJECTIVE: To compare outcomes with simultaneous administration of mifepristone and misoprostol with a regimen in which the drugs are administered at a 24-hour interval for second-trimester abortion. METHODS: In this placebo-controlled, double-blind trial, participants were randomized to receive mifepristone either 24 hours before or at the same time as misoprostol. Participants were hospitalized to receive 400 micrograms buccal misoprostol at 3-hour intervals up to 48 hours or until uterine expulsion...
October 6, 2016: Obstetrics and Gynecology
Monica V Dragoman, Daniel Grossman, Nathalie Kapp, Nguyen My Huong, Ndema Habib, Duong Lan Dung, Anand Tamang
BACKGROUND: Pain is often cited as one of the worst features of medical abortion. Further, inadequate pain management may motivate some women to seek unnecessary clinical care. There is a need to identify effective methods for pain control in this setting. METHODS/DESIGN: We propose a randomized, placebo-controlled trial. 576 participants (288 nulliparous; 288 parous) from study sites in Nepal, South Africa and Vietnam will be randomly allocated to one of three treatments: (1) ibuprofen 400 mg PO and metoclopramide 10 mg PO; (2) tramadol 50 mg PO and a placebo; or (3) two placebo pills, to be taken immediately before misoprostol and repeated once four hours later...
October 12, 2016: Reproductive Health
J V Turner, S Agatonovic-Kustrn, Hrg Ward
Clinical use of drugs is approved for specified clinical indication, route of administration, dose and population group. Off-label prescribing of a registered medicine occurs outside of these parameters and may be justified by pharmacology and physiology, as well as sufficient evidence from published clinical trials and reviews. Misoprostol and mifepristone in combination have recently been registered in Australia for medical termination of pregnancy in women of child-bearing age. There is good clinical evidence for efficacy and safety of misoprostol in uterine evacuation in both miscarriage and termination of pregnancy...
December 28, 2015: Facts, Views & Vision in ObGyn
Zahra Dehbashi, Mahmood Moosazadeh, Mahdi Afshari
BACKGROUND: Each year, more than forty million abortions are occurred whole of the world. Misoprostol is a prostaglandin analogue with a strong uterotonic effect. The present study aimed to compare the efficacy of Misoprostol in first trimester abortion through two sublingual and vaginal routes of administration. METHODS: This randomized clinical trial was conducted on 52 consecutive women in first trimester candidate for pregnancy termination because of fetal IUFD or missed abortion in sonography reports...
July 24, 2016: Materia Socio-medica
S Badir, E Mazza, M Bajka
PURPOSE: The goal of this study was to objectively quantify cervical stiffness in misoprostol users prior to IUC insertion and at follow-up consultation to evaluate the feasibility of assessing cervical stiffness and to study the influence of misoprostol on cervical softening. MATERIALS AND METHODS: This was a cross-sectional study that evaluated 40 women who wished to use the LNG IUS. These women were evaluated immediately before LNG IUS insertion and 6 weeks later at follow-up consultation...
May 2016: Ultrasound Int Open
Kate A Shaw, Klaira Lerma
PURPOSE OF REVIEW: To review the recent literature on surgical second-trimester abortion, with specific attention to cervical preparation techniques. RECENT FINDINGS: Confirming previous studies, a recent retrospective observational cohort study, including 54 911 abortions, estimated the total abortion-related complication rate to be 0.41% for second-trimester or later procedures. Cervical preparation is known to reduce risks associated with second-trimester dilation and evacuation (D&E)...
September 28, 2016: Current Opinion in Obstetrics & Gynecology
Cui-Lan Li, Li-Ping Song, Shi-Yan Tang, Lee Jaden Gil Yu-Kang Zhou, Hong He, Xue-Tang Mo, Yi-Ming Liao
The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration...
September 27, 2016: Reproductive Sciences
Mohammad Ahmed Maher, Tarek Mohammad Sayyed, Nabih Ibrahim Elkhouly
OBJECTIVES: To compare between three different utertonics (oxytocin, carbetocin, and misoprostol) given via three different routes (intra-umbilical, intravenous, and sublingual, respectively) in reducing the need for manual removal of placenta. METHODS: A randomized trial for cases with retained placenta 30 minutes following vaginal delivery. They received intraumbilical oxytocin, intravenous carbetocin, or sublingual misoprostol. Main outcome measures were delivery of the placenta within 30 minutes following drug administration, and need for manual removal of placenta...
September 27, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jill Durocher, Laura J Frye, Beverly Winikoff
No abstract text is available yet for this article.
October 2016: Obstetrics and Gynecology
Ying Hua, Wenwen Zhang, Xiaoli Hu, Ansu Yang, Xueqiong Zhu
The effects of misoprostol use on cervical priming prior to hysteroscopy have been controversial. Therefore, a systematic literature review and meta-analysis of studies were conducted to assess the effect of misoprostol on cervical priming prior to hysteroscopy. All studies published before July 2014 with data related to the use of misoprostol for cervical priming compared with placebo or no medication prior to hysteroscopy, were identified. Twenty-five randomized controlled trials involving 2,203 females were systematically analyzed...
2016: Drug Design, Development and Therapy
Prasanna Latha Akkenapally
OBJECTIVE: To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14-20 weeks) . MATERIALS AND METHODS: The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women. Group-I received only misoprostol; 600 mcg initial vaginal insertion followed by 400 mcg sublingually every 3 h until termination...
October 2016: Journal of Obstetrics and Gynaecology of India
Gaurav Shyam Desai, Abhishek Chandavarkar, Sriram Gopal, Ganpat Sawant, Shyam V Desai
CONTEXT: Intravaginal placement of misoprostol has been used extensively to terminate second trimester pregnancies. Intracervical misoprostol is an alternative method of termination of pregnancy for women in this period of gestation. OBJECTIVE: To assess the efficacy and safety of combined intracervical and intravaginal misoprostol in the management of mid-trimester medical termination of pregnancy and to compare it with intravaginal misoprostol. MATERIALS AND METHODS: In this IRB approved prospective study, twenty-two women (mean age 25...
October 2016: Journal of Obstetrics and Gynaecology of India
Braganza Veena, Rajinish Samal, Leeberk R Inbaraj, Carolin Elizabeth George
BACKGROUND: Prostaglandins are popular agents for induction of labour, owing to their dual action of cervical ripening and inducing uterine contractions. Sublingual misoprostol offers high efficacy as it bypasses first-pass metabolism. Researchers have proved that intracervical PGE1 is as effective as PGE2 except for increased caesarean rate and hyperstimulation. Limited knowledge is available on the efficacy of sublingual PGE1 and intracervical PGE2. This study was designed to compare the effectiveness of sublingual PGE1 with intracervical PGE2...
October 2016: Journal of Obstetrics and Gynaecology of India
Hossam Hassan Aly Hassan El Sokkary
AIM: The aim of the present study is to compare between sublingual administration of misoprostol and vaginal administration in the management of missed abortion. MATERIALS AND METHODS: The study was conducted in El-Shatby Maternity Hospital on 160 patients diagnosed as missed abortion by ultrasonographic examination. Cases were divided into two groups according to the methods of misoprostol administration, whether sublingual or vaginal. Patients of the two groups were observed for the times of uterine colic starting, cervical dilation, and conceptus expulsion, along with recording of any side effects...
October 2016: Journal of Obstetrics and Gynaecology of India
E Zohav, A Alasbah, O Segal, L Green, M Volodarski, A Namazov, E Anteaby, O Gemer
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Cristine Kolling Konopka, Verônica Farina Azzolin, Francine Carla Cadoná, Alencar Kolinski Machado, Eduardo Bortoluzzi Dornelles, Fernanda Barbisan, Ivana Beatrice Mânica da Cruz
Misoprostol, prostaglandin E1 analogue, used for labour induction. However, one-third of patients who have labour induced with prostaglandins do not reach vaginal delivery. The differential expression of prostaglandin receptors in myometrial cells could account for this differential response. Since delivery physiology also involves modulation of oxidative metabolism that can be potentially affected by pharmacological drugs, in the present investigation the role of misoprostol on expression of prostaglandin receptors, and oxidative markers of myometrial cells was evaluated...
September 16, 2016: Prostaglandins & Other Lipid Mediators
J Park, H Park, C Jung, S Kim, B Kim, K Hwang, T Lee, H Jeon
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Sven Kehl, Lena Böhm, Christel Weiss, Jutta Heimrich, Ulf Dammer, Friederike Baier, Marc Sütterlin, Matthias W Beckmann, Florian Faschingbauer
AIM: The best time to commence cervical ripening with a balloon catheter is unknown. The aim of this study was to evaluate whether application of a balloon catheter in the morning or in the evening is better when sequential prostaglandin application is planned. METHODS: This multicenter historical cohort study included 415 women with an unfavorable cervix undergoing labor induction at term. Labor was induced with a double-balloon catheter and the sequential use of oral misoprostol if necessary...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
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