ABSTRACT
We describe five pitfalls of medical abortion: ectopic pregnancy not terminated after misoprostol, but without negative side-effects; long-term vaginal blood loss with suspicious retained products which disappeared spontaneously; a patient with uterus myomatatosus with severe pain and retained products in the uterus; repetition of misoprostol because of retained products in the uterus after two weeks and an allergic reaction to methotrexate. Despite these pitfalls, there are enough benefits to consider medical abortion with methotrexate and misoprostol as a safe method with a high success rate of more than 91% and a good alternative for surgical abortion. An invasive procedure is not necessary, there are no long-term complications and it can be performed at an earlier stage, which makes it more acceptable in society. In Curaçao, where abortion is legally restricted, medical abortion is performed with methotrexate and misoprostol. In countries where abortion is legal, mifepristone and misoprostol are the first choice.
Describimos cinco riesgos del aborto medico: el embrazo ectópico no terminado después de misoprostol, pero sin efectos secundarios negativos; la pérdida de sangre vaginal a largo plazo sin productos retenidos sospechosos que desaparecieron espontáneamente; una paciente con útero miomatoso con dolor severo y productos retenidos en el útero; repetición del misoprostol debido a productos retenidos en el útero después de dos semanas y una reacción alérgica al metotrexato. A pesar de estas dificultades, hay suficientes beneficios para considerar el aborto médico con metotrexato y misoprostol como un método seguro con una alta tasa de éxito superior al 91%, y como una buena alternativa al aborto quirúrgico. No se requiere un procedimiento invasivo, no hay complicaciones a largo plazo, y puede realizarse en una etapa más temprana, lo que resulta más aceptable para la sociedad. En Curazao, donde el aborto está legalmente restringido, el aborto médico se realiza con metotrexato y misoprostol. En países donde el aborto es legal, la mefepristona y el misoprostol son la primera elección.
Subject(s)
Adult , Female , Humans , Pregnancy , Young Adult , Abortifacient Agents/administration & dosage , Abortion, Induced/methods , Misoprostol/administration & dosage , Administration, Intravaginal , Dilatation and Curettage , Leiomyomatosis/complications , Leiomyomatosis , Pregnancy Complications, Neoplastic , Treatment FailureABSTRACT
BACKGROUND: Unsafe abortion is a major cause of mortality among women in India accounting for 12% of all maternal deaths. In developing countries, annually, up to 200,000 women die of complications after illegal abortion. Medical abortion is potentially a simple and a safe method for use in developing countries. We conducted a prospective controlled trial to compare the efficacy of low-lose mifepristone and methotrexate for medical abortion. OBJECTIVE: To find out the efficacy of low-dose mifepristone and methotrexate for inducing abortion. METHOD: In this prospective clinical study, 100 women opted for a medical method of abortion. Out of these, 50 patients were given 50 mg/m2 of methotrexate intramuscularly followed by 800 micro gm of intravaginal misoprostol, and 50 patients were given 200 mg of mifepristone orally followed by 800 micro gm of intravaginal misoprostol. MAIN OUTCOME MEASURES: Complete abortion was the principal outcome measure. Secondary outcome measures were side effects and acceptability data. RESULTS: The rate of expulsion by first week after initiation of treatment was 58% in methotrexate and 98% in mifepristone group (P <0.001). CONCLUSION: Low-dose mifepristone and intravaginal misoprostol is safe, effective, and well tolerated as compared to methotrexate and misoprostol.
Subject(s)
Abortifacient Agents/administration & dosage , Abortion, Induced/methods , Adult , Chi-Square Distribution , Drug Therapy, Combination , Female , Humans , Methotrexate/administration & dosage , Mifepristone/administration & dosage , Misoprostol/administration & dosage , Pregnancy , Prospective Studies , Treatment OutcomeABSTRACT
O extrato benzênico de flores de Hibiscus rosa sinensis foi administrado a ratas grávidas, desde o dia 1§ ao 10§ de gestaçäo (dose: 200 mg/kg peso corporal), com o objetivo de confirmar seu efeito abortivo. Os resultados obtidos näo confirmam os dados da literatura, uma vez que näo ocorreram efetios embriotóxicos ou zigotóxicos do extato. É possível que os resultados conflitantes se devam, ao fato de planta ser cultivada em solo e climas diferentes e, talvez, muitos os resultados dicrepantes em estudos de plantas possam ser devido ao local onde a planta foi obtida