Joyce van den Berg1, Johan M van den Bent2, Marcus P Snijders3, Roel de Heus4, Sjors F Coppus2, Frank P Vandenbussche2. 1. Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Electronic address: j.vandenberg@cwz.nl. 2. Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands. 3. Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. 4. Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Abstract
OBJECTIVE: Is treatment of early pregnancy failure (EPF) with sequential use of mifepristone and misoprostol more effective than treatment with misoprostol alone? STUDY DESIGN: In a retrospective cohort study at the Department of Obstetrics and Gynaecology of the Radboud University Medical Centre, 301 women with early pregnancy failure receiving medical treatment between January 2008 and March 2013 were included. Of these, 199 women were pre-treated with 200mg mifepristone (orally) followed by 2 consecutive doses of 800mcg misoprostol (vaginally) and 102 women were treated with 2 consecutive doses of 800mcg misoprostol (vaginally) alone. RESULTS: Complete expulsion was achieved in 66.8% of the women treated with a sequential combination of mifepristone and misoprostol versus 54.9% of the women treated with misoprostol alone. The difference in rates of complete expulsion was 11.9% (P<0.05; 95% CI 0.3-23.6%). CONCLUSIONS: Medical treatment of early pregnancy failure with a sequential combination of mifepristone and misoprostol was more effective than treatment with misoprostol alone. Our findings will have to be confirmed by a large prospective multicentre double blinded-randomized trial.
OBJECTIVE: Is treatment of early pregnancy failure (EPF) with sequential use of mifepristone and misoprostol more effective than treatment with misoprostol alone? STUDY DESIGN: In a retrospective cohort study at the Department of Obstetrics and Gynaecology of the Radboud University Medical Centre, 301 women with early pregnancy failure receiving medical treatment between January 2008 and March 2013 were included. Of these, 199 women were pre-treated with 200mg mifepristone (orally) followed by 2 consecutive doses of 800mcg misoprostol (vaginally) and 102 women were treated with 2 consecutive doses of 800mcg misoprostol (vaginally) alone. RESULTS: Complete expulsion was achieved in 66.8% of the women treated with a sequential combination of mifepristone and misoprostol versus 54.9% of the women treated with misoprostol alone. The difference in rates of complete expulsion was 11.9% (P<0.05; 95% CI 0.3-23.6%). CONCLUSIONS: Medical treatment of early pregnancy failure with a sequential combination of mifepristone and misoprostol was more effective than treatment with misoprostol alone. Our findings will have to be confirmed by a large prospective multicentre double blinded-randomized trial.
Authors: Joyce van den Berg; Charlotte C Hamel; Marcus P Snijders; Sjors F Coppus; Frank P Vandenbussche Journal: BMC Pregnancy Childbirth Date: 2019-11-27 Impact factor: 3.007
Authors: Charlotte Hamel; Sjors Coppus; Joyce van den Berg; Esther Hink; Jacoba van Seeters; Paul van Kesteren; Ashley Merién; Bas Torrenga; Rafli van de Laar; Josien Terwisscha van Scheltinga; Ingrid Gaugler-Senden; Peppino Graziosi; Minouche van Rumste; Ewka Nelissen; Frank Vandenbussche; Marcus Snijders Journal: EClinicalMedicine Date: 2021-01-06
Authors: Charlotte C Hamel; Marcus P L M Snijders; Sjors F P J Coppus; Frank P H A Vandenbussche; Didi D M Braat; Eddy M M Adang Journal: PLoS One Date: 2022-02-09 Impact factor: 3.240