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Title: Studies with an antiprogesterone in early and mid trimester pregnancy
Author: Rodger, Mary Wallace
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2000
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In this thesis safety, efficacy and acceptability of early medical abortion with mifepristone and the prostaglandin analogue gemeprost are investigated in Chapters 2,3 and 5. In Chapter 4 the mechanism of abortion with these agents is explored. The use of a single dose of 400 mg, 500 mg or 600 mg of mifepristone followed 48 hours later by a half or a whole 1 mg gemeprost pessary was shown to induce complete abortion in 95% of women of £ 56 days amenorrhoea. No significant differences were demonstrated between the three treatment regimes. When 600 mg of mifepristone was given with either a half or a whole gemeprost pessary, women receiving the smaller dose of prostaglandin experienced significantly less severe pain. Abortion rates were not compromised by a reduction in the dose of prostaglandin with 98% of women receiving a half pessary aborting, compared with 100% of women receiving a whole pessary. Pretreatment with mifepristone or gemeprost 48 hours prior to the administration of 1 mg gemeprost was also studied. Measurement of uterine tone with an intrauterine pressure catheter showed that while pretreatment with gemeprost had no effect on uterine tone following a further dose of gemeprost, pretreatment with mifepristone exerted a significant effect. In addition, the pattern of uterine activity following gemeprost or mifepristone pretreatment was shown to differ. Blood loss was measured during and after the induction of abortion with mifepristone and gemeprost in 222 consecutively treated women of <63 days of amenorrhoea. The median loss <56 days amenorrhoea was 72 mls. Blood loss was found to increase with increasing gestation and was significantly greater in women treated between 56 and 63 days of amenorrhoea. Although the introduction of prostaglandins to gynaecological practice has improved midtrimester abortion techniques, it remains a long, unpleasant and relatively high risk procedure.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available