Clinical Literature

Question 1

We currently use 200mg of Mifepristone as the prostaglandin analogue. What dose did they used to use?

Answer 1

600mg.

This was shown to be too high in RCTs and a meta-analysis.

Question 2

How can Misoprostol (GyMiso) be administered?

Answer 2

• Orally
• Vaginally
• Buccally
• Sublingually

Question 3

At how many days of gestation is Misoprostol no longer effective?

what is the comparison of mifepristone+misoprostol vs misoprostol only?

Answer 3

49 days

Question 4

In Australia, how is Misoprostol Approved and Administered?

Answer 4

If <= 63 days then:

• Mifepristone 200mg orally at the clinic.
• 36-48 Hours later take Misoprostol 800mcg Buccally at home.

Question 5

Is Buccal Administration more effective than Vaginal administration of misoprostol?

Answer 5

No. They are equally effective. (95% oral vs 93% vaginal)

Question 6

Is Buccal Administration more effective than Oral Administration?

Answer 6

Yes.

This is minimal up to 49 days.

But after this there is a significant difference.

At 63 days 95% (buccal) vs 85% (Oral)

Question 7

When is Uterine Myometrium most sensitive to prostaglandin analogues after mifepristone administration?

Answer 7

36-48 hours

Question 8

What is the MTOP Failure rate?

Answer 8

3.5%

• 2.9% incomplete abortions
• 0.6% Continuing pregnancies.

Question 9

What is the chance of infection?

what is the chance of haemorrhage?

Answer 9

0. 2%
1. 1%

Question 10

What was the abortion success rate of MS 2 Step at <49 days and between 49-63 days?

Answer 10

97% vs 95%