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A Comparison of Two Dosing Regimens of Intravaginal Misoprostol for First and Second- Trimesters Pregnancy Termination

المقارنة بين طريقتين في استخدام الميزوبروستول عن طريق المهبل لإنهاء الحمل في ثلثية الأول و المتوسط

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 Publication date 2003
and research's language is العربية
 Created by Shamra Editor




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Objective: To compare the effectiveness of Misoprostol administered intravaginally every 12 versus 6 hours for termination of pregnancy in the first and second trimesters. Methods: Fifty six pregnant patients at 7 – 22 weeks of gestation were randomized to receive 800 μg (first trimester) and 200 μg either every 12 or every 6 hours for 48 hours. Results: The incidence of abortion within 48 hours after initial dose, in the first trimester was 100% in the two groups, in the second trimester the incidences were 95.5 and 100%. The incidences of abortion by a single dose in the first trimester were 85 and 10% in the 12 and 6 hours groups respectively (P <0.001) The mean abortion intervals 8.3 , 20.2 and 12.4 hours in the 12 and 6 hour group respectively. Side effects were similar in both groups. Conclusion: Misoprostol administered vaginally is effective for termination of first and second trimester pregnancies in non scared uterus. Giving the medication at a shorter interval from 12 to 6 hours appeared to have no significant benefit.


Artificial intelligence review:
Research summary
تهدف هذه الدراسة إلى مقارنة فعالية دواء الميزوبروستول عند إعطائه عن طريق المهبل كل 12 ساعة مقابل كل 6 ساعات لإنهاء الحمل في الثلثين الأول والثاني من الحمل. شملت الدراسة 56 مريضة حامل تتراوح أعمار حملهن بين 7 و22 أسبوعًا، وتم تقسيمهن عشوائيًا لتلقي 800 ميكروغرام (للثلث الأول) و200 ميكروغرام إما كل 12 ساعة أو كل 6 ساعات لمدة 48 ساعة. أظهرت النتائج أن نسبة الإجهاض خلال 48 ساعة بعد الجرعة الأولى كانت 100% في الثلث الأول في كلا المجموعتين، بينما كانت النسب في الثلث الثاني 95.5% و100% على التوالي. كانت نسبة الإجهاض بجرعة واحدة في الثلث الأول 85% و10% في مجموعتي 12 و6 ساعات على التوالي (P <0.001). كانت الفترات الزمنية المتوسطة للإجهاض 8.3 و20.2 و12.4 ساعة في مجموعتي 12 و6 ساعات على التوالي. كانت الآثار الجانبية مشابهة في كلا المجموعتين. خلصت الدراسة إلى أن الميزوبروستول عند إعطائه عن طريق المهبل فعال في إنهاء الحمل في الثلثين الأول والثاني في الرحم غير المتندب، وأن إعطاء الدواء بفاصل زمني أقصر من 12 إلى 6 ساعات لم يظهر فائدة كبيرة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تقدم معلومات قيمة حول فعالية الميزوبروستول في إنهاء الحمل. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا شملت عددًا أكبر من المشاركات، مما يزيد من قوة النتائج. ثانيًا، لم تتناول الدراسة بشكل كافٍ الآثار الجانبية المحتملة على المدى الطويل لاستخدام الميزوبروستول بفواصل زمنية مختلفة. أخيرًا، كان من المفيد تضمين مجموعة مقارنة تستخدم طرقًا أخرى للإجهاض لتقديم سياق أوسع للنتائج.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو مقارنة فعالية دواء الميزوبروستول عند إعطائه عن طريق المهبل كل 12 ساعة مقابل كل 6 ساعات لإنهاء الحمل في الثلثين الأول والثاني من الحمل.

  2. ما هي النتائج الرئيسية للدراسة؟

    النتائج الرئيسية للدراسة أظهرت أن نسبة الإجهاض خلال 48 ساعة بعد الجرعة الأولى كانت 100% في الثلث الأول في كلا المجموعتين، بينما كانت النسب في الثلث الثاني 95.5% و100% على التوالي. كانت نسبة الإجهاض بجرعة واحدة في الثلث الأول 85% و10% في مجموعتي 12 و6 ساعات على التوالي.

  3. ما هي الفترات الزمنية المتوسطة للإجهاض في مجموعتي 12 و6 ساعات؟

    كانت الفترات الزمنية المتوسطة للإجهاض 8.3 و20.2 و12.4 ساعة في مجموعتي 12 و6 ساعات على التوالي.

  4. هل كانت هناك فوائد كبيرة لإعطاء الدواء بفاصل زمني أقصر؟

    لم تظهر الدراسة فائدة كبيرة لإعطاء الدواء بفاصل زمني أقصر من 12 إلى 6 ساعات.


References used
Altman D G. How large a sample ? In: Gore S M, Altman D G, eds. Statistics in Practice. London: British Medical Association, 1982: 6- 8
Garris R E, Kirkwood C F. Misoprostol: A prostaglandin E-1 analogue Clin pharm 1989; 8:627-644
Herting R L, Nissen C H. Overview of misoprostol clinical experience. Dig Dis Sci 1986; 31 (suppl 2) : 47s-54s
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In this study , 103 pregnant women with the diagnosis of missed abortion in the second trimester of pregnancy had been accepted to terminate the pregnancy, by one of two methods : In the first group (53 patients ) we used vaginal Misoprostol (cyto tec ) ; in the second group (50 patients) we used the classic method by insertion of Foley catheter followed by induction of uterine contractions by oxytocine . (intravenous infusion ) .
Abortion is the most common complication of early pregnancy, so that should be effectively managed with safe and appropriate procedures. Surgical evacuation of the uterus for management of first trimester abortions usually involves vacuum aspiration or sharp curettage. Objective:To compare the complications of electric vacuum aspiration (EVA) and sharp curettage (D&C) for first trimester abortions, and detect the method that ensure more safety and efficacy. Subjects and methods: The study included one hundred women with incomplete abortion, missed abortion or blighted ovum, gestational age less than 12 weeks whom come to the department of obstetrics and gynecology at Al-Assad university hospital in Lattakia , Syria between 1 July 2013 and 1 July 2014. They were allocated into two groups, group A (n = 50) underwent EVA and group B (n=50) underwent D&C. The procedures were performed using the general anesthesia. We excluded: febrile state, clotting disorders, sever medical and surgical complications, unstable hemodynamic state. Results: Clinical characteristics were similar in the two groups. There were no reports of maternal deaths, cervical laceration, uterine perforation or blood transfusion recorded in the two groups. Blood loss was greater with D&C group than with EVA group (0.001). need an analgesic was greater with D&C group than with EVA group (0.002). Duration of operation and hospitalization was significantly shorter with EVA group than with D&C group. The two groups were similar in success procedure. Conclusion: The efficacy of EVA was the same as that of D&C in successful the procedure, but pain and blood loss were experienced more in the D&C group.
This study was organized to find out the role and the efficacy of Misoprostol in treating postpartum hemorrhage unresponsive to traditional agents that contract the uterus . Place : Maternity hospital at Faculty of Medicine in Damascus university Time : from 2, January, 2004 to 2, January, 2005 . Number of patients : 18 patients who met the criteria in that period of time . Criteria of selection : any patient with post partum hemorrhage due to uterine atony that did not respond well to the administration of Oxytocin and Metergin . Misoprostol is an effective treatment of post partum hemorrhage due to uterine atony unresponsive to Oxytocin and Metergin. Our study confirms the results of international studies of effectiveness of the use of misoprostol in treating post partum hemorrhage due to uterine atony.
This study aimed at arranging the items of cognitive abilities test (primary battery) by using Rash s one parameter model , In addition ,different forms for interpreting the individuals level of ability were carried out. The test was conducted on a sample of (1081) students from Lattakia schools and kindergarten . using "SPSS" program and Winsteps for statistical treatment in accordance with Rasch Model. The results showed the necessity of omitting (38) items of cognitive abilities test because they were not fitting the model. The remain items that were left were (172). And proved the validity and the reliability of the test. Moreover, the present study form criteria for percentiles rank, T scores, and standardized intelligent quiescent that equal for the different individual ability.
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