Systematic review on efficacy of mifepristone and misoprostol combination on early trimester medical termination of pregnancy

Abstract

Introduction: Mifepristone, also known as RU 486 is used to cause medical abortion during the early part of pregnancy. It is used up to 10 weeks of pregnancy. Mifepristone blocks the secretion of progesterone. Misoprostol is an analogue of prostaglandin that increases uterine contraction and cervical dilation. The combination of both is used in studies with variable efficacy for medical abortion. Objective: To find out the efficacy of mifepristone and misoprostol combination by systematic review of studies from different parts of the world. Materials and Methods: Literature search in internet was conducted with the topic of efficacy of mifepristone and misoprostol combination on early trimester medical termination of pregnancy. Sixteen articles were finalized after applying the review criteria. Four large trials on the efficacy of mifepristone and misoprostol conducted in USA and Australia and 12 studies from different parts of the world were included. Most of the studies are randomised control trials and descriptive type. Results: It was found that the efficacy of mifepristone and misoprostol varied from 70.93% to 100% with a mean of 92.19%. The time interval between intake of mifepristone and misoprostol, and complete abortion varied from 10 hrs to 24 hrs. Conclusion: Systematic review detected the mean efficacy of mifepristone and misoprostol combination to be 92.19%. Keywords: Early trimester termination of pregnancy, Efficacy, Mifepristone, Misoprostol, Systematic review.