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Women
on mifepristone must be apprised about the high rate of bleeding onset prior to
the use of misoprostol.
A
recent study published in the Maternal-Fetal Medicine Journal found that
terminated bleeding after 2 weeks is a predictive indicator for effective
medical induction of early pregnancy loss (EPL).
This prospective observational cohort study by Simon-Hermann Enzelsberger et al. was performed with an intent to improve counselling of women by reporting bleeding characteristics at home following the medical management of an EPL with mifepristone and misoprostol and to assess the bleeding patterns as a predictive tool.
A total of 197 women who presented with an EPL were enrolled. They chose mifepristone 200 mg and misoprostol 800 mcg for home-based medical management. Starting with the intake of mifepristone, a diary was maintained by the patient where vaginal bleeding was noted daily for 14 days. Treatment success was defined as no earlier recognized retained products of conception (RPOC) in 3 months. Finally, 154 women were included in the analysis keeping in view all drop-out criteria.
The
occurrence of bleeding was reported by 40.0% of patients amid mifepristone and
misoprostol intake. The median span of vaginal bleeding including spotting was
13 days. The likelihood of RPOC was around 6 times in the group of persistent
bleeding than terminated bleeding group after 2 weeks. A possible link between
elevated serum levels of leukocytes at treatment beginning with RPOC was
revealed.
Maternal-Fetal Medicine
Bleeding pattern after medical management of early pregnancy loss with mifepristone–misoprostol and its prognostic value: a prospective observational cohort study
Simon-Hermann Enzelsberger et al.
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