S.No
|
Author, year
|
Methods
|
Setting
|
Participants
|
Interventions
|
|
Blanchard et al 2005
|
Randomized controlled trial
|
KEM Hospital in Pune,
India, and Hungvuong Hospital in Ho Chi Minh City, Vietnam.
|
Women seeking pregnancy termination at 56 days or less of amenorrhea. All eligible women had a transvaginal ultrasound scan to confirm duration of pregnancy.
|
Misoprostol oral 400 μg every 3 hours for 4 doses (N=36)
vs.
Misoprostol oral 800 μg every 6 hours for 2 doses (N=24)
vs.
Misoprostol vaginal 600 μg for 1 dose (N=40)
|
|
Blum et al 2012
|
Randomized controlled trial
|
Two large maternity hospitals: the Centre de Maternite et Neonatologie de la Rabta in Tunisia (n=193) and Hung Vuong Hospital, Ho Chi Minh City, Vietnam (n=248).
|
Pregnant women presenting for early medical abortion up to 63 days since their last menstrual period.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg on day 1 and 800 μg buccal misoprostol followed by placebo 3 hours later on day 2 (N=220)
vs.
Misoprostol alone
Placebo on day 1 and 1600 μg of misoprostol (2 doses of 800 μg, given 3 hours apart) on day 2 (N=221)
|
|
Chai et al 2013
|
Randomized controlled trial
|
Conducted at the Family Planning Association in Hong Kong.
|
Healthy women aged 18 years or older who requested termination of pregnancy of up to 63 days’ gestation. A transvaginal ultrasound examination
was performed to verify the duration of pregnancy and to determine the gestational age.
|
Misoprostol buccal
Misoprostol buccal 800 μg (four 200 μg misoprostol buccal and four sublingual placebo) 48 hours after receiving mifepristone (N=45)
vs.
Misoprostol sublingual
Misoprostol sublingual 800 μg (four 200 μg misoprostol sublingual and four buccal placebo) 48 hours after receiving mifepristone (N=45)
|
|
Chawdhary et al 2009
|
Randomized controlled trial
|
Department of Obstetrics and Gynecology, Tribhuvan
University Teaching Hospital, Kathmandu, Nepal.
|
Trans vaginal ultrasound demonstrating an intact single intrauterine pregnancy up to a 63-day period of gestation.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg on day 1 and vaginal misoprostol 800 μg on day 3 (N=50)
vs.
Misoprostol alone
Misoprostol vaginal (800 μg) on day 1 and 3 (total dose 1600 μg) (N=50)
|
|
Chong et al 2012
|
Randomized controlled trial
|
Three clinics in the Republic of Georgia and at Hoc Mon Hospital in Vietnam.
|
Women who presented for termination of pregnancy with gestations up to 63 days since LMP.
|
Misoprostol buccal 400 μg
Misoprostol buccal 400 μg (two 200 μg misoprostol and two placebo pills) 36-48 hours after mifepristone (N=559)
vs.
Misoprostol buccal 800 μg
Misoprostol buccal 800 μg (four 200 μg misoprostol pills) 36-48 hours after mifepristone (N=563)
|
|
Coyaji et al 2007
|
Randomized controlled trial
|
K.E.M. Hospital in Pune (n = 150) and the Health Centre, Larsen and Toubro Limited, Mumbai, India (n = 150).
|
Women seeking termination of
pregnancies could participate if they had amenorrhoea of 8 weeks or less.
|
Two doses of misoprostol
Two doses of 400 μg oral misoprostol
taken in 3 hours interval 48 hours after mifepristone (N=150)
vs.
Single dose of misoprostol
Single dose of 400 μg oral misoprostol and 2 placebo tablets 3 hours later 48 hours after mifepristone (N=150)
|
|
Creinin et al 2007
|
Randomized controlled trial
|
Four centers: The University
of Pittsburgh, Oregon Health and Science University, Northwestern University, and the University of Southern California. The University of Pittsburgh served as the sponsoring institution.
|
Healthy women requesting an elective abortion, had an intrauterine pregnancy less than or equal to 63 days of gestation on the day of mifepristone administration as confirmed by vaginal ultrasound.
|
Misoprostol 800 μg vaginal immediately after taking mifepristone (N=567)
vs.
Misoprostol 800 μg vaginal misoprostol 24 hours after taking mifepristone (N=561)
|
|
Dahiya et al 2011
|
Randomized controlled trial
|
Postpartum center at PGIMS Rohtak, India.
|
Healthy women with intrauterine pregnancy <56 days based on menstrual history and clinical examination.
|
Misoprostol oral 400 μg 24 h after mifepristone (N=48)
vs.
Misoprostol sublingual 400 μg 24 h after mifepristone (N=45)
|
|
Dahiya et al 2012
|
Randomized controlled trial
|
Outpatient department of Obstetrics and Gynecology of Pt BDSharma PGIMS, Rohtak, India.
|
Women with amenorrhea <56 days, age >18 years, request for elective abortion with the indication as per the guidelines of the 1971 MTP act.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg oral and 800 μg buccal misoprostol after 24 hours (N=50)
vs.
Misoprostol alone
Misoprostol buccal 800 μg (N=50)
|
|
El-Refaey et al 1994
|
Randomized controlled trial
|
Department of Obstetrics and Gynaecology, University of Aberdeen
|
Women requesting termination of pregnancy of less than 56 days amenorrhea confirmed by ultrasound scan examination and fulfilling the criteria of the 1967 Abortion Act.
|
Misoprostol oral 800 μg single dose 36-48 hours after mifepristone (N=75)
vs.
Misoprostol oral 400 μg repeated 2 hours later 36-48 hours after mifepristone (N=75)
|
|
El-Refaey et al 1995
|
Randomized controlled trial
|
Fertility-control clinic, Aberdeen Royal Hospitals,
Aberdeen, Scotland.
|
Women requesting termination
of pregnancy within 63 days from the onset of amenorrhea and fulfilling the criteria of the 1967 Abortion Act.
|
Misoprostol oral 800 μg 36-48 hours after mifepristone (N=130)
vs.
Misoprostol vaginal 800 μg 36-48 hours after mifepristone (N=133)
|
|
Fekih et al 2010
|
Randomized controlled trial
|
Department of Obstetrics and Gynecology in Farhat Hached Teaching Hospital, Sousse, Tunisia.
|
Women requesting 1st trimester abortion of less than or equal to 56 days from their last menstrual
period, determined by vaginal probe ultrasound and a maximum
embryonic length of 17 mm.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg followed
by 400 μg of oral misoprostol after 48 hours (N=126)
vs.
Misoprostol alone
Misoprostol sublingual 800 μg (repeated every 4 hours for up to a maximum of 3 doses) (N=126)
|
|
Goel et al 2011
|
Randomized controlled trial
|
Obstetrics and Gynaecology Department, MMIMSR, Mullana (Ambala), Haryana, India.
|
Healthy pregnant women, who were
requesting an elective abortion and had a single intrauterine pregnancy of <7 weeks (49 days) of gestation as confirmed by transvaginal ultrasonography.
|
Misoprostol vaginal 400 μg simultaneously with mifepristone (N=40)
vs.
Misoprostol vaginal 400 μg 24 hours after mifepristone (N=40)
|
|
Guest et al 2007
|
Randomized controlled trial
|
Ninewells Hospital, Dundee, Scotland.
|
An IUP confirmed on pelvic ultrasound scan, gestation not exceeding 63 days at the administration of mifepristone and participants must be aged 16 years or older, seeking a termination of pregnancy.
|
Misoprostol vaginal 800 μg after 6 hours of mifepristone (N=225)
vs.
Misoprostol vaginal 800 μg after 36–48 hours of mifepristone (N=225)
|
|
Hamoda et al 2005
|
Randomized controlled trial
|
Aberdeen Royal Infirmary, United Kingdom.
|
Women with a viable singleton IUP (confirmed by transvaginal ultrasound scan) requesting medical abortion up to 13 weeks of gestation. Data aggregated by gestational age.
|
Misoprostol sublingual 600 μg followed 3 hours later by a further dose of 400 μg sublingual misoprostol (N=57)
vs.
Misoprostol vaginal 800 μg followed 3 hours later by a further dose of 400 μg vaginal misoprostol (N=72)
|
|
Jain et al 2002
|
Randomized controlled trial
|
Women’s and Children’s Hospital and affiliated clinics, Los Angeles County-University of Southern California Medical Center and San Francisco General Hospital, University of California, San Francisco, United States.
|
A total of 250 healthy women desiring termination of pregnancies < 56 days gestation were enrolled.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg followed after 48 hours by 800 μg of vaginal misoprostol (repeated every 24 hours for up to a maximum of 3 doses) (N=125)
vs.
Misoprostol alone
Placebo on day 1 and misoprostol vaginal 800 μg repeated every 24 hours for up to a maximum of 3 doses (N=125)
|
|
Middleton et al 2005
|
Randomized controlled trial
|
Two sites in Rochester, NY, United States.
|
Women seeking abortion with pregnancies through 56 days LMP.
|
Misoprostol buccal 800 μg 1-2 days after mifepristone (N=223)
vs.
Misoprostol vaginal 800 μg 1-2 days after mifepristone (N=219)
|
|
Ngoc et al 2011
|
Randomized controlled trial
|
Tertiary hospital in Ho Chi Minh City, Vietnam.
|
Women with GA up to 63 days by LMP, living and working within an hour from the hospital desiring medical abortion.
|
Mifepristone + misoprostol combined
Mifepristone 200 mg followed 24 hour later by 800 μg buccal misoprostol followed by placebo 24 hours later after misoprostol (N=202)
vs.
Misoprostol alone
Placebo followed by 800 μg buccal misoprostol repeated 24 and 48 hours later (1,600 μg total) (N=198)
|
|
Prasad et al 2009
|
Randomized controlled trial
|
Department of Obstetrics
and Gynecology, Maulana Azad Medical College, New Delhi, India.
|
Women with GA up to 49 days confirmed by clinical examination and pelvic ultrasound seeking abortion.
|
Medical abortion-misoprostol vaginal 800 μg (N=70)
vs.
Surgical intervention (N=70)
|
|
Raghavan et al 2009
|
Randomized controlled trial
|
University Clinic, Municipal Clinical Hospital No.1, Chisinau, the Republic of Moldova.
|
The date of onset of last menses plus
pelvic examination were used to calculate gestational age, with ultrasound confirmation as needed.
|
Misoprostol sublingual 400 μg 24 hours after mifepristone (N=240)
vs.
Misoprostol oral 400 μg 24 hours after mifepristone (N=240)
|
|
Raghavan et al 2010
|
Randomized controlled trial
|
University Clinic, Municipal Clinical Hospital No.1, Chisinau, the Republic of Moldova.
|
Women with gestational age through 63 days by LMP presenting for abortion. Gestational age was determined by one or more assessment method: last menses method, pelvic examination and
ultrasound.
|
Misoprostol buccal 400 μg 24 hours after mifepristone (N=277)
vs.
Misoprostol sublingual 400 μg 24 hours after mifepristone (N=273)
|
|
Schaff et al 2000
|
Randomized controlled trial
|
Sixteen US primary care and referral abortion facilities.
|
Participants were at least 18 years old, no more than 56 days pregnant, healthy and desired an abortion.
|
1) Misoprostol vaginal 800 μg 1 day later after mifepristone (N=745)
vs.
2) Misoprostol vaginal 800 μg 2 days later after mifepristone (N=778)
vs.
3) Misoprostol vaginal 800 μg 3 days later after mifepristone (N=772)
|
|
Schaff et al 2001
|
Randomized controlled trial
|
Multicenter study at 15 sites in United States.
|
Women no more than 63 days pregnant, confirmed by sonogram, desiring an abortion.
|
Misoprostol oral 800 μg 24 hours after mifepristone and 400 μg, then another 400 μg misoprostol 2 hours later, last dose no later than midnight on day 2 (N=548)
vs.
Misoprostol vaginal 800 μg 24 hours after mifepristone (N=596)
|
|
Schaff et al 2002
|
Randomized controlled trial
|
Multicenter study at 14 sites in United States
|
Women no more than 63 days pregnant, confirmed by sonogram, desiring an abortion.
|
1) Misoprostol oral 400 μg 48 hours after mifepristone (N=220)
vs.
2) Misoprostol oral 800 μg 48 hours after mifepristone (N=269)
vs.
3) Misoprostol vaginal 800 μg 48 hours after mifepristone (N=522)
|
|
Shannon et al 2006
|
Randomized controlled trial
|
Three clinics associated with major research universities in
Canada; two in major urban areas and one in a periurban area.
|
Women aged 16 years or older, seeking elective abortion of pregnancies less than 56 days since last menstrual period or on vaginal ultrasound.
|
1) Misoprostol oral 400 μg 24-48 hours after mifepristone (N=319)
vs.
2) Misoprostol oral 600 μg 24-48 hours after mifepristone (N=319)
vs.
3) Misoprostol vaginal 800 μg 24-48 hours after mifepristone (N=318)
|
|
Tang et al 2003
|
Randomized controlled trial
|
Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
|
Women with gestational age of less than 9 weeks, confirmed by US, requesting legal termination of
pregnancy.
|
Misoprostol sublingual
Misoprostol sublingual 800 μg (and four tablets of vaginal placebo) 48 hours after receiving mifepristone (N=112)
vs.
Misoprostol vaginal
Misoprostol vaginal 800 μg (and four tablets of sublingual placebo) 48 hours after receiving mifepristone (N=112)
|
|
Tendler et al 2015
|
Randomized controlled trial
|
Department of Obstetrics and Gynecology, Galilee Medical
Center, Nahariya, Israel.
|
Women no more than 55 days gestational age desiring medical abortion.
|
Misoprostol oral 400 μg 2 hours after mifepristone (N=50)
vs.
Misoprostol oral 400 μg 48 hours after mifepristone (N=50)
|
|
Verma et al 2011
|
Randomized controlled trial
|
Department of Obstetrics and Gynaecology, Hind Institute of Medical Sciences, India.
|
Women less than 63 days of gestation choosing medical abortion.
|
Misoprostol vaginal 400 μg 24 hours after mifepristone (N=100)
vs.
Misoprostol vaginal 400 μg 48 hours after mifepristone (N=100)
|
|
Verma et al 2017
|
Randomized controlled trial
|
Department of Obstetrics and Gynaecology, Hind Institute of Medical Sciences, India.
|
Women up to 63 days of gestation choosing medical abortion.
|
Misoprostol vaginal 400 μg simultaneously with mifepristone (N=100)
vs.
Misoprostol vaginal 400 μg 48 hours after mifepristone (N=100)
|
|
Von Hertzen et al 2007
|
Randomized controlled trial
|
Eleven gynecological centers in six countries.
|
Women with single intra-uterine pregnancy less than or equal to 63 days verified by US, requesting termination of pregnancy.
|
1) Misoprostol 800 μg sublingual every 3 hours x 3 doses (N=517)
vs.
2) Misoprostol 800 μg sublingual every 12 hours x 3 doses (N=516)
vs.
3) Misoprostol 800 μg vaginal every 3 hours x 3 doses (N=516)
vs.
4) Misoprostol 800 μg vaginal every 12 hours x 3 doses (N=517)
|
|
Von Hertzen et al 2009
|
Randomized controlled trial
|
Thirteen departments of obstetrics and gynecology in nine countries.
|
Women with 63 days or less gestation verified by ultrasound, requesting termination of pregnancy.
|
1) Mifepristone 100 mg + misoprostol 800 μg vaginal 24 hours later (N=545)
vs.
2) Mifepristone 100 mg + misoprostol 800 μg vaginal 48 hours later (N=547)
vs.
3) Mifepristone 200 mg + misoprostol 800 μg vaginal 24 hours later (N=544)
vs.
4) Mifepristone 200 mg + misoprostol 800 μg vaginal 48 hours later (N=545)
|
|
Von Hertzen et al 2010
|
Randomized controlled trial
|
Fifteen obstetrics/gynecology departments in ten countries.
|
Women requesting legal termination of pregnancy at a gestation of up to 63 days.
|
1) Mifepristone 200 mg + misoprostol 400 μg sublingual 24 hours later (N=751)
vs.
2) Mifepristone 200 mg + misoprostol 800 μg sublingual 24 hours later (N=752)
vs.
3) Mifepristone 200 mg + misoprostol 400 μg vaginal 24 hours later (N=751)
vs.
4) Mifepristone 200 mg + misoprostol 800 μg vaginal 24 hours later (N=751)
|
|
Winikoff et al 2008
|
Randomized controlled trial
|
Seven facilities in the United States.
|
Women seeking medical abortion with pregnancies not exceeding 63 days since the LMP on the day of the medical abortion. Gestational age was determined by LMP, clinical examination, and/or ultrasonography,
as needed.
|
Misoprostol oral 800 μg 24-36 hours after mifepristone (N=482)
vs.
Misoprostol buccal800 μg 24-36 hours after mifepristone (N=484)
|