Comparative study on the efficacy of mifepristone versus mifepristone and misoprostol in the induction of labor in cases of intrauterine fetal demise

Background: This study aimed to compare the efficacy of two labor induction methods, mifepristone alone and mifepristone followed by misoprostol, in cases of intrauterine fetal demise (IUFD) beyond 28 weeks of gestation.Methods: A prospective study was carried out at, BRD Medical College in Gorakhpur and aimed to investigate the efficacy of two different methods for labor induction in pregnancies with intrauterine fetal demise (IUFD) beyond 28 weeks of gestation during September 2019 to August 2020. Sixty participants were divided into two groups of 30 each, with mifepristone administered orally in both groups. Group 2 received additional vaginal misoprostol. Patient demographics, Bishop scores, induction to active labor intervals, and induction to delivery intervals were examined. Augmentation methods, side effects, complications, and time to full dilatation were analyzed.Results: The groups exhibited similar patient characteristics, including age, parity, socioeconomic status, and literacy rates. Gestational age at induction and Bishop scores were comparable. Both groups showed substantial improvements in Bishop scores. The induction to active labor interval was shorter in the mifepristone group, and the induction to delivery interval was similar. The mifepristone group required fewer mifepristone tablets, while the combination group used less misoprostol, reducing side effects. Complications were minimal, with a decreased need for augmentation methods in both groups.Conclusions: Mifepristone, whether used alone or followed by misoprostol, proved effective in labor induction for IUFD beyond 28 weeks. Mifepristone's ability to enhance cervical ripening and prostaglandin sensitivity makes it a promising option for reducing the risks associated with delayed birth in cases of IUFD. These findings suggest that mifepristone can be a valuable addition to obstetric practices, particularly in cases where traditional induction methods may pose greater risks.

Glucocorticoid hypersensitivity syndrome: A case report and review of literature / 中华内分泌代谢杂志

This article reports a patient with typical Cushing syndrome′s manifestations and extremely low plasma cortisol level, indicating glucocorticoid hypersensitivity syndrome. After treatment with the glucocorticoid receptor antagonist mifepristone, the patient′s Cushing symptoms were significantly relieved, and cortisol levels returned to normal. The aim of this report is to enhance clinical awareness among physicians regarding glucocorticoid hypersensitivity syndrome.

Advances in the Diagnosis and Treatment of Cushing′s Syndrome / 罕见病研究

Cushing′s syndrome (CS), an endocrine disorder resulting from excessive glucocorticoid secretion by the adrenal cortex, poses significant challenges to both diagnosis and treatment. The diagnostic process involves comprehensive evaluation, combining laboratory tests and imaging studies for screening, qualification, and localization. Surgical intervention remains the primary treatment approach, although pharmacological therapy also plays a crucial role. With an increasing understanding of the pathogenesis of CS, more potential targets for orphan drug development have been discovered. This article summarizes the current status of diagnosis and treatment for CS and provides an outlook on future research directions.

Role of mifepristone in preinduction cervical ripening and induction of labour at term: an observational study

Background: Induction implies stimulation of uterine contractions before spontaneous onset of labour. It is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. Of the various medical methods of induction, prostaglandins and oxytocin remain the most popular and acceptable methods in obstetric practice. Mifepristone is a steroid compound, with anti-progesterone activity. It increases uterine activity and causes cervical dilatation and effacement. We intend to study the role of oral mifepristone in preinduction cervical ripening and induction of labour in term pregnancies.Methods: In a prospective observational study carried out from Jan 2023 to June 2023 at a zonal hospital, 100 antenatal women at term with Bishop score less than 6 participated. Tablet mifepristone 200 mg single dose was given orally for induction. All patients were assessed after 24 hours for cervical ripening, need for augmentation, mode of delivery, maternal and neonatal outcome.Results: It was observed that there was a significant improvement in Bishop score 24 hours after giving mifepristone. Out of 100 women in the study, 82% delivered vaginally, 15% had caesarean section and 3% had instrumental delivery. 21% needed no second method of labour induction. 76% patients delivered within 48 hrs of ingestion of mifepristone. The majority of patients had good maternal and neonatal outcome.Conclusions: Mifepristone is an effective and safe method for preinduction cervical ripening and induction of labour in term pregnancies.

Efficacy and safety of oral mifepristone on preinduction cervical ripening at term pregnancy prospective randomized control study

Background: Cervical ripening is important prerequisite for induction of labour, induction is indicated when it is advantageous to mother and fetus. Successful induction of labour decreases caesarean rate. Beyond term pregnancy there will be placental insufficiency, it leads to complications such as oligohydramnios thereby cord compression, birth asphyxia, increased incidence of operative delivery. Induction at term pregnancy has the potential to improve the neonatal outcomes. Aim was to study the efficacy and safety of oral mifepristone on cervical ripening prior to induction of labor at term pregnancy and to compare the feto maternal outcome with control group.Methods: Total 112 pregnant women at term pregnancy, where pregnancy can be continued for another 48 hours with bishop score 4 or less were selected. Sample was equally divided into study group (56 women) to receive 200mg mifepristone and control Group group (56 women) to receive placebo orally. Bishop score was assessed at 24hours and 48hours. In women who did not enter labor spontaneously other modes of induction was done.Results: There is significant improvement in bishop score at 24 hr and 48hr in study group p value 0.001, 80.35% women in study group and 50 % women in control group delivered vaginally. 33.9% women of study group and 10.7% women of control group delivered spontaneously. Requirement of PGE2 gel and oxytocin was significantly lesser in study group, there was no significant adverse effect seen on mother and newborn compared to control group.Conclusions: Cervical ripening with mifepristone prior to induction of labour at term improves bishop score and decreases rate of failed induction and cesarean section rate, with good neonatal outcome.

Uso de mifepristona en embarazo ectópico intersticial: un reporte de caso / Use of mifepristone in an interstitial ectopic pregnancy: a case report

Introducción: El embarazo ectópico intersticial es una forma de presentación poco frecuente, con una incidencia del 2-4% de los embarazos ectópicos; sin embargo, a pesar de su baja incidencia la mortalidad es cinco veces mayor, impactando en las cifras de mortalidad materna y representando en torno al 10-15% de los casos. Objetivo: Presentar un caso de embarazo ectópico intersticial, cuya ocurrencia es poco frecuente, así como el abordaje satisfactorio del manejo médico con mifepristona y metotrexato. Caso clínico: Mujer de 28 años con antecedente de resección tubárica por quiste paraovárico derecho, quien acudió a urgencias por hallazgo en ecografía obstétrica de sospecha de embarazo intersticial izquierdo y se le administró manejo farmacológico con dosis de metotrexato y mifepristona, con éxito. Conclusiones: El manejo médico con metotrexato y mifepristona para el embarazo ectópico intersticial parece ser una elección eficaz en los casos con estabilidad hemodinámica y deseo de conservación de la fertilidad.

Background: Interstitial ectopic pregnancy represents a rare form of presentation, with an incidence of 2-4% of all ectopic pregnancies. However, despite its low incidence, it is associated with a five-fold increase in mortality, significantly impacting maternal mortality rates, accounting for approximately 10-15% of cases. Objective: To present a case of interstitial ectopic pregnancy, which is a rare occurrence, as well as the successful medical management approach with mifepristone and methotrexate. Case report: A 28-year-old women with a history of right paraovarian cyst tubal resection presented to the emergency department due to suspected left interstitial pregnancy identified on obstetric ultrasound. The patient was successfully managed with pharmacological treatment using doses of methotrexate and mifepristone. Conclusions: Medical management with methotrexate and mifepristone for interstitial ectopic pregnancy appears to be an effective choice in cases with hemodynamic stability and a desire for fertility preservation.

A study on the effect of mifepristone on uterine fibroids

Background: Uterine fibroids are the most common pelvic tumors and most common benign tumors in women. Abnormal uterine bleeding and pain are common symptoms of fibroids. The objective of study was to study the effect of mifepristone on uterine fibroids on the basis of change in menstrual pattern, hemoglobin level, fibroid volume and alleviation of pain.Methods: This prospective study had sample size of 40 subjects with uterine leiomyomas who were recruited from OPD after taking an informed written consent. Follow up of each subject was done after 3 months to see changes in various parameters after giving 3 months of mifepristone 25 mg once daily. Study tools included case reporting form, ultrasonography, blood investigations, pictorial blood loss assessment chart (PBAC) to compare change in menstrual pattern and visual analogue pain scale for comparing alleviation in pain.Results: In this study, the majority of patients belonged to 41-45 years of age and were para 1 with dominant symptom of menorrhagia. At the end of 3 months the mean baseline fibroid volume decreased by 37.5%, mean hemoglobin improved from 9.37 to 11.05 gm/dl, mean PBAC score reduced from 90.6 to 8.9, 25% of patients had no pain and pain score in 32.5% patients was 1 and in 32.5% patients pain score was 2.Conclusions: Three months treatment with 25 mg mifepristone daily, effectively controls bleeding, reduces fibroid volume ameliorates pain and abnormal bleeding, improves hemoglobin. It can be recommended as the optimum clinical treatment of fibroids in this dose.

A study on the effect of mifepristone on uterine fibroids

Background: Uterine fibroids are the most common pelvic tumors and most common benign tumors in women. Abnormal uterine bleeding and pain are common symptoms of fibroids. The objective of study was to study the effect of mifepristone on uterine fibroids on the basis of change in menstrual pattern, hemoglobin level, fibroid volume and alleviation of pain.Methods: This prospective study had sample size of 40 subjects with uterine leiomyomas who were recruited from OPD after taking an informed written consent. Follow up of each subject was done after 3 months to see changes in various parameters after giving 3 months of mifepristone 25 mg once daily. Study tools included case reporting form, ultrasonography, blood investigations, pictorial blood loss assessment chart (PBAC) to compare change in menstrual pattern and visual analogue pain scale for comparing alleviation in pain.Results: In this study, the majority of patients belonged to 41-45 years of age and were para 1 with dominant symptom of menorrhagia. At the end of 3 months the mean baseline fibroid volume decreased by 37.5%, mean hemoglobin improved from 9.37 to 11.05 gm/dl, mean PBAC score reduced from 90.6 to 8.9, 25% of patients had no pain and pain score in 32.5% patients was 1 and in 32.5% patients pain score was 2.Conclusions: Three months treatment with 25 mg mifepristone daily, effectively controls bleeding, reduces fibroid volume ameliorates pain and abnormal bleeding, improves hemoglobin. It can be recommended as the optimum clinical treatment of fibroids in this dose.

Role of combination of mifepristone and misoprostol versus misoprostol alone in the management of late intrauterine fetal death

Background: Intrauterine fetal death (IUFD) occurs in 1% of pregnancies and has devastating consequences. Previous methods for inducing labor in IUFD involved oxytocin and prostaglandins. The combination of mifepristone and misoprostol is commonly used for early first-trimester termination. This study aimed to compare the effectiveness of mifepristone and misoprostol combination versus misoprostol alone for labor induction in intrauterine fetal death.Methods: A randomized controlled clinical trial was conducted at Sir Salimullah Medical College, Mitford Hospital, Dhaka, from January 2017 to June 2017. Sixty-four pregnant women with intrauterine fetal death after 28 weeks of gestation were included. Participants were randomly assigned to either group-I (mifepristone and misoprostol) or group-II (misoprostol alone). Statistical analyses were performed using statistical package for the social sciences (SPSS) version 20.0 for Windows.Results: The mean age was 27.7±5.6 years in group I and 27.5±4.3 years in group II. Majority of patients in group I were housewives (87.5%), while in group II, it was 78.1%. Most patients in group I (56.3%) came from lower-income families, compared to 65.6% in group II. The gestational age did not significantly differ between the groups. The induction to delivery interval was significantly shorter in group I (8.6±2.0 hours) compared to group II (15.1±3.5 hours). The dose administration pattern of misoprostol differed significantly between the groups.Conclusions: Both methods are equally safe and effective for managing intrauterine fetal death. However, the combination of mifepristone and misoprostol showed greater efficacy in terms of reducing the induction to delivery interval and requiring a lower dose of misoprostol.

Outcomes of early first trimester medical termination of pregnancy: retrospective study

Background: Unsafe abortion is a major public health problem. Globally, 20 million unsafe abortions occur each year, accounting for 13% of all maternal deaths. According to WHO, 56% of abortions in developing countries are still unsafe even though medical abortion methods have been used for over a decade. The main objective of the present study is to compare the efficacy, acceptability, side effects and factors affecting the outcome of early medical abortion with oral and vaginal misoprostol after oral mifepristone in inducing early medical abortion up to 8 weeks of gestation.Methods: A one-year retrospective, observational study was conducted. A total of 82 post-MTP patients were included in this study. Data retrieved from the hospital database was tabulated and analysed.Results: The majority of women who underwent the procedure fell into the age group of 26-30 years (32.9%), on observing the parity of the mothers a whopping 82.9% were multiparous. The finished family (41.5%) was the most common reason for MTP. The incidence of RPOC in the study group was 31.7%. About 26.8% of the patients did not come back for follow-up.Conclusions: The majority of women who underwent the procedure fell into the age group of 26-30 years (32.9%), on observing the parity of the mothers a whopping 82.9% were multiparous. The finished family (41.5%) was the most common reason for MTP. The incidence of RPOC in the study group was 31.7%. About 26.8% of the patients did not come back for follow-up.

Induction of labour in pregnancies with fetal demise: a randomised control trial

Background: The present study aims at comparing efficacy and safety of two different regimens of induction of labour (IOL) in pregnancies with fetal demise.Settings and Design: A randomised controlled trial was conducted on 100 eligible pregnant women diagnosed with intrauterine fetal demise who were admitted in the labour ward of a tertiary care hospital.Methods: All participants were randomly divided into two groups in group A and group B. In Group A, IOL was done with transcervical foley’s catheter and vaginal misoprostol while in group B, mifepristone with vaginal misoprostol were used for IOL. During intrapartum period the mode of delivery, induction-delivery interval, total dose of induction agent used and amount of total blood loss were noted. Any side effect if present was also noted.Results: Comparing both the groups, Induction delivery interval was less in group A as compared to group B.Conclusions: Use of mifepristone with misoprostol as well as Foley’s with misoprostol were found to be equally safe and effective methods.

A study on role of low dose mifepristone in the management of fibroid in reproductive age group women

Background: Uterine fibroids are the most common benign uterine tumors occurring in 20-50% of women with maximum incidence between 35-45 years of age. Majority of fibroids are asymptomatic. When symptomatic, they present with abnormal menstrual bleeding, dysmenorrhea, chronic pelvic pain, abdominal heaviness, pressure symptoms etc. It is the commonest indication of hysterectomy worldwide. Mifepristone, an antiprogesterone is being widely used as one of the medical managements in potential symptomatic patients (mostly 10-20 mg daily doses).Methods: An institute based prospective study including 100 reproductive aged women with symptomatic single uterine fibroid, was conducted over one-and-a-half-year period. They were administered 10 or 25 mg mifepristone daily for 3 months depending on fibroid size. Clinical parameters were assessed at initiation and at the end of their treatment.Results: Our results showed that mifepristone (both 10 and 25 mg) led to symptomatic relief, with 96% reduction in menstrual blood loss and reversible amenorrhoea in 87% of the patients. Intramural fibroids responded more than submucosal fibroids in terms of relief of menorrhagia and improvement of haemoglobin (Hb) levels, with similar reduction in fibroid volumes of both intramural and submucosal locations.Conclusions: Low dose mifepristone is an effective and safe drug for the medical management of uterine myoma. Due to the benign nature of fibroids, conservative management should be considered wherever feasible. Several clinical trials using 5?50 mg of mifepristone have been conducted over variable durations between 3-12 months but the exact dosage and treatment duration are yet to be decided.

A comparative study of efficacy of two different regimens of vaginal misoprostol in first trimester termination of pregnancy in a tertiary care hospital

Background: Misoprostol has been authorised as an effective medication for termination of pregnancy at different gestations, cervical ripening, labour inducing in term pregnancy, and possibly therapy of postpartum haemorrhage in the last two decades. Objectives were to compare the efficacy of two different regimens of vaginal misoprostol in first trimester termination of pregnancy.Methods: This was a randomized controlled trial conducted among 50 women in the reproductive age group with single live intrauterine gestation less than 12 weeks. All patients including both groups received mifepristone 200 mg oral administration as day 1 followed by group A received misoprostol 800 mg stat after 36 hours of mifepristone and group B received misoprostol 400 mg stat after 36 hours of mifepristone followed by 200 mg at 6 hourly 2 doses.Results: The mean age of the study participants was 26.48±3.77 and 24.72±3.33 in group A and B respectively. The 20% and 16% in group A had repeat dose and dilatation and curettage (D and C) done whereas only 8% had D and C done in group B. There was no significant difference between the prevalence side effects between the groups. Group B showed higher dissatisfaction than group A. The 36% and 8% of the study participants in group A and B respectively had incomplete abortion.Conclusions: Multidose regimen is found to be more effective in the first trimester termination of pregnancy than the single dose regimen.

Mifepristone alone versus mifepristone-misoprostol combination regimen for management of intrauterine fetal death

Background: Early pregnancy failure is a common complication of pregnancy. If women do not abort spontaneously, they will undergo medical or surgical treatment in order to remove the products of conception from the uterus. Curettage, although highly effective, is associated with a risk of complications; medical treatment with misoprostol is a safe and less expensive alternative. Unfortunately, after 1 week of expectant management in case of EPF, medical treatment with misoprostol has a complete evacuation rate of approximately 50%. Misoprostol treatment results may be improved by pre-treatment with mifepristone; its effectiveness has already been proven for other indications of pregnancy termination. The study objective was to compare the outcome of Mifepristone alone with the Mifepristone- Misoprostol combination regimen for the management of IUFD.Methods: This was a Prospective clinical trial at the department of obstetrics and gynecology, Chittagong Medical College Hospital, Chittagong. From March 2016 (Actual patient enrolment started after obtaining ethical clearance i.e. March 2018) to September 2018.Results: A subjects delivered earlier than group B and the mean induction delivery interval in Group A is significantly less in comparison to Group B (p=<0.001). Out of 50 women, 2(4%) and 10(20%) women in Groups A and B required oxytocin infusion to establish good contractions, and completion of termination who regarded as a failure. In the mifepristone alone group, the success rate is significantly higher than in the combination group.Conclusions: The efficacy of mifepristone alone was found superior to that of the mifepristone misoprostol combination regimen in the present study.

Effectiveness of mifepristone versus balloon catheter in induction of labour in women with previous caesarean sections: a randomised comparative study

Background: Termination of pregnancy is a stressful situation for the patient specially due to increasing trend of caesarean sections (CS) wherein due to risk of scar rupture a repeat caesarean is advocated by many practitioners. Especially in these cases vaginal delivery should be preferred over CS to avoid the added stress of a major surgery to the woman which increases the risk of scar rupture and adhesions in subsequent pregnancies. Hence the aim was to compare the safety and effectiveness of mifepristone versus balloon catheter in termination of pregnancy in women with previous CS.Methods: Prospective randomized comparative study was done at obstetrics and gynaecology department of Teerthankar Mahaveer medical college and research centre, Moradabad UP from January 2020 to July 2021. 60 subjects were randomised into 2 groups by the envelope method.Results: The mean bishops score at 36 hours was found to be 10.2±1.25 and 9.81±1.54 in groups M and B respectively. No statistically significant difference was found between the bishops score of the two groups at 24 and 36 hours. Patients induced with mifepristone had significantly longer induction delivery, Induction augmentation and Induction-labour intervals. However, these patients ultimately had more number favourable outcomes in terms of vaginal delivery, although not statistically significant. Conclusions: Foleys insertion is an invasive and painful process and more uncomfortable for the patient. Mifepristone can safely be used in place of foleys catheter for induction of labour in patients with previous 1 CS.

Evaluation of the Clinical Effect of High-Intensity Focused Ultrasound and Drug Conservative on the Treatment of Cesarean Scar Pregnancy / 实用妇产科杂志

Objective:To evaluate the clinical effect of high-intensity focused ultrasound(HIFU)and drug con-servative treatment on the treatment of type Ⅰ and type Ⅱ cesarean scar pregnancy(CSP).Methods:A retrospec-tive analysis was performed on 191 patients diagnosed with type Ⅰ and type Ⅱ CSP by ultrasonography and trea-ted in Mianyang Central Hospital from January 2018 to December 2021,and they were divided into drug group(n=67)and HIFU group(n=124)according to different treatment methods before curettage surgery.After receiv-ing conservative drug treatment or HIFU treatment,preformnegative pressure suction curettage under ultrasound monitoring to evaluate the effectiveness and safety of the two pretreatment methods.Results:There were no sig-nificant differences in age,number of cesarean sections,gestational age,the maximum diameter of the gestational sac,number of incision pregnancies,the β-hCG level before pretreatment,the heart tube pulse in the gestational sac,size of fetal bud,and fertility requirements between the medication group and HIFU group(P＞0.05).The proportion of type Ⅱ incision in HIFU group was higher than that in drug group(P＜Q.05).There were no signifi-cant differences between the two groups in intraoperative bleeding,treatment outcome effective rate after pretreat-ment,postoperative vaginal bleeding duration,postoperative uterine cavity residual,rate of reoperation and rate of repregnancy(P＞0.05).There were statistical differences between the two groups in the operation time of curet-tage surgery,whether the operation method was changed after pre-treatment,total hospital stay,β-hCG recovery time and hospitalization cost(P＜0.05).Following up to November 2022,there were 12 cases re-pregnancies in the drug group and 16 cases re-pregnancies in the HIFU group.Conclusions:For type Ⅰ and type Ⅱ CSP,HIFU pretreatment before negative pressure suction curettage under ultrasound monitoring is a safe and effective treat-ment,which improves the treatment effect and reduces the hospitalization time of patients.It may be an effective clinical therapy for type Ⅰ and type Ⅱ CSP treatment.

Retrospective cohort study on the efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy / 中国药房

OBJECTIVE To investigate the efficacy of Methotrexate （MTX） injection combined with Mifepristone tablets in the treatment of ectopic pregnancy. METHODS A retrospective cohort study method was used to collect data on patients with ectopic pregnancy who visited the Affiliated Hospital of Chengdu University from January 1， 2013 to December 31， 2021. Control group was given MTX injection alone， and exposure group was given MTX injection combined with Mifepristone tablets. Baseline variables were balanced between the two groups using a propensity score matching （PSM）， and the outcomes of the matched cohorts were compared. RESULTS A total of 125 patients were included， involving 68 in the control group and 57 in the exposure group. After PSM， 46 cases in each group were successfully matched. There was no significant difference in the treatment response rate and the incidence of adverse drug reaction （ADR） between the exposure group and the control group， which were 73.91% and 63.04%， 21.74% and 13.04% （P＞0.05）. Compared with before treatment， serum levels of β-HCG were all significantly decreased in 2 groups after treatment （P＜0.05）； there was no significant difference in the serum level of β-HCG after treatment， the time to return to normal， the interval time of second pregnancy， second ectopic pregnancy and second intrauterine pregnancy between 2 groups （P＞0.05）. The mean diameter difference of B-ultrasound pregnancy mass before and after treatment， duration of clinical symptom remission and length of hospital stay in the exposure group were significantly higher than those in the control group （P＜ 0.05）， but drug costs during hospitalization and total hospitalization costs were not significantly increased （P＞0.05）. There were no significant difference between single-dose group and multi-dose group of MTX in the treatment response rate and the incidence of ADR （P＞0.05）. The hospitalization time， drug cost and total cost of the single dose group were significantly less than those of the multi-dose group （P＜0.05）. CONCLUSIONS MTX injection combined with or without Mifepristone tablet can both effectively treat ectopic pregnancy， with comparable efficacy and safety. MTX single-dose regimen is similar to the multi-dose regimen in efficacy， but the multi-dose regimen increases the hospital stay and hospitalization costs.

Meta analysis of levonorgestrel releasing intrauterine system and mifepristone in the treatment of adenomyosis / 中国医师杂志

Objective:To evaluate the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) (mirena) versus mifepristone therapy for adenomyosis.Methods:We retrived the Cochrane library, the Pubmed, EMbase, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, China Biomedical Literatue Database (CBM) and other databases to identify randomized controlled trials (RCTs) involving the comparison of levonorgestrel-releasing intrauterine system and mifepristone up to October 2018. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Then data were analyzed with Stata 11.0 software.Results:A total of 17 RCTs involving 1 772 patients were included. The results indicated that mirena was more effective than mifepristone [RR=1.25, 95% CI(1.19, 1.32), P<0.01]. The decrease in endometrial thickness [MD=-1.94, 95% CI(-2.19, -1.70), P<0.01], uterine volume [MD=-18.99, 95% CI(-19.90, -18.07), P<0.01] and the incidence of adverse reactions [RR=0.67, 95% CI(0.47, 0.95), P=0.026] in mirena group were significantly different compared with the mifepristone group. Also the dysmenorrhea score and menstrual blood volume of mirena group were lower than mifepristone group ( P<0.05). Conclusions:Current evidence shows that the efficacy and safety of mirena was better than mifepristone in the treatment for adenomyosis patients. Since the limitation of quantity and quality of included studies, large-scale high-quality RCTs are needed to verify the above conclusion.

Effect of electroacupuncture at / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of the combination of electroacupuncture (EA) at @*METHODS@#A total of 58 patients after uterine curettage of incomplete abortion were randomized into an EA group and a western medication group, 29 cases in each one. In the western medication group, mifepristone tablets were administered orally, 2 tablets each time, once daily. In the EA group, on the base of the treatment as the western medication group, EA was applied to @*RESULTS@#After treatment, the intrauterine residue area and CDFI blood flow signal positive rate were all reduced as compared with the values before treatment in patients of the two groups (@*CONCLUSION@#The combined treatment of electroacupuncture at

Thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis.@*METHODS@#Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. The patients in the the control group were treated with oral administration of mifepristone, 10 mg each time, once a day; based on the treatment of the control group, the patients in the observation group were treated with thunder-fire moxibustion at Guanyuan (CV 4), Zigong (EX-CA 1), Xuehai (SP 10), once every other day. Both the groups were treated for 3 months. The Cox menstrual symptom scale (CMSS) score, the maximum cross-sectional area of ectopic cyst, and the serum levels of transforming growth factor-β1 (TGF-β1) and interleukin-17 (IL-17) were observed before and after treatment in the two groups. The clinical efficacy was evaluated.@*RESULTS@#Compared before treatment, the severity scores and duration scores of CMSS as well as the serum levels of TGF-β1 were reduced after treatment in the two groups (@*CONCLUSION@#Thunder-fire moxibustion combined with mifepristone could significantly improve dysmenorrhea symptoms, shorten dysmenorrhea time and promote atrophy of ovarian heterotopic cyst in patients with ovarian chocolate cyst dysmenorrhea of kidney deficiency and blood stasis, and the mechanism may be related to the reduction of serum levels of TGF-β1 and IL-17.