Mifepristone or vacuum aspiration in termination of early pregnancy.

This trial compared the termination of early pregnancy (amenorrhoea less than 43 days) by 600 mg orally of the antiprogesteron Mifepristone to the traditional method of vacuum aspiration. Fifty women were randomly assigned to either of the treatments. All the patients treated with vacuum aspiration had a complete abortion. Three of these patients developed pelvic inflammatory diseasae (PID) after the aspiration. Another patient had the uterus perforated during the procedure, and an emergency laparotomy had to be performed. The patients in the evacuation group spent more days in bed and needed longer sick leave after the treatment than the patients in the Mifepristone group. In the Mifepristone group, six patients had incomplete abortions and all were treated by evacuation. Three of the patients developed PID after the evacuation. A decrease of 40% or more in beta hCG from the initial value to the value 1 week later were invariably associated with complete abortion. In both groups the changes in hemoglobin were insignificant and no patients needed blood transfusion or emergency evacuation. The Mifepristone treatment is a simple and safe alternative to vacuum aspiration for termination of early pregnancies.

PIP: This trial compared the termination of early pregnancy (amenorrhea less than 43 days) by 600 mg mifepristone, an antiprogesterone, to traditional method of vacuum aspiration. 50 women were randomly assigned to either of the treatments. All patients who underwent vacuum aspiration had a complete abortion. 3 of these patients developed pelvic inflammatory disease (PID) following aspiration. Another patient experienced a uterine perforation during the procedure, and an emergency laparotomy was performed. The patients in the evacuation group spent more days in bed and needed more sick leave after the treatment than the patients in the mifepristone group. In that group, 6 patients had incomplete abortions and all were treated with evacuation. 3 developed PID after the procedure. A decrease of 40% or more ion the beta-hCG from the initial value to the value 1 week later wee invariably associated with complete abortion. In both groups, the changes in hemoglobin were insignificant and no patients needed blood transfusions or emergency evacuations. The mifepristone treatment is simple and a safe alternative to vacuum aspiration for termination of early pregnancies.

Hysterosalpingography, pre- and postoperative laparoscopy in operative treatment of infertility.

The benefit of routine hysterosalpingography (HSG) and pre- and postoperative laparoscopy in diagnosing and treating anatomical infertility was investigated in 115 women. The findings at HSG and laparoscopy were compared with the diagnoses obtained by laparotomy. Laparoscopy was significantly better than HSG in detecting adhesions. Both procedures were of equal value in assessing tubal pathology. Although HSG revealed additional findings in 5 per cent of cases, none of these needed operative correction. Postoperative laparoscopy, which was performed in 70 patients, did not affect the incidence of either intra- or extra-uterine pregnancy. It is concluded that all patients should be offered diagnostic laparoscopy. HSG and second-look laparoscopy should not be used routinely.