000			03622nam a22005297a 4500
008			170411s20162016 xxu||||| |||| 00| 0 eng d
022			_a0010-7824
040			_aOvid MEDLINE(R)
099			_a26948184
245			_aA randomized controlled trial evaluating same-day mifepristone and misoprostol compared to misoprostol alone for cervical preparation prior to second-trimester surgical abortion.
251			_aContraception. 94(2):127-33, 2016 Aug
252			_aContraception. 94(2):127-33, 2016 Aug
253			_aContraception
260			_c2016
260			_fFY2017
266			_d2017-05-24
501			_aAvailable online from MWHC library: 1995 - present
520			_aCONCLUSION: The addition of mifepristone to vaginal misoprostol did not provide a significant increase in cervical dilation compared to misoprostol alone as cervical preparation 4-6h prior to D&E at 14weeks through 19weeks 6days.
520			_aCopyright (c) 2016 Elsevier Inc. All rights reserved.
520			_aIMPLICATIONS: Adding mifepristone for a short interval (4-6h) did not improve cervical preparation with misoprostol prior to D&E at 14-19weeks. Future studies should evaluate alternative timing intervals of medications for this purpose.
520			_aOBJECTIVE: We evaluated initial cervical dilation with the addition of oral mifepristone to vaginal misoprostol as cervical preparation for same-daysecond-trimester dilation and evacuation (D&E).
520			_aRESULTS: Of 100 women enrolled, 96 were randomized and completed the study. Age, race, gestational age (mean 17.4weeks, SD=1.3) and parity did not significantly differ. Mean initial Hegar dilation measurements were 11.7 and 10.9mm in the mifepristone and placebo groups, respectively, with difference of 0.8 [95% CI=-0.4, 2.0mm]. We found total procedure times of 11.8 and 13.0min, respectively (difference of 1.2min [95% CI=-2.4, 4.8min]. Participant and provider perceptions did not differ. All 96 procedures were completed without hemorrhage, cervical laceration or other observed complications.
520			_aSTUDY DESIGN: Women desiring abortion between gestational ages 14weeks 0days and 19weeks 6days were randomized to 200-mg mifepristone or identical placebo immediately followed by 400-mcg misoprostol vaginally 4-6h prior to D&E. Primary outcome was cervical dilation assessed by largest Hegar dilator passed without resistance. Secondary outcomes included total procedure time and participant and provider perceptions. We had 90% power to detect a 2-mm change in initial cervical dilation with a mean of 10mm (SD=3.0mm), requiring 48 participants in each arm.
546			_aEnglish
650			_a*Abortifacient Agents, Steroidal/ad [Administration & Dosage]
650			_a*Abortion, Induced/mt [Methods]
650			_a*Labor Stage, First/de [Drug Effects]
650			_a*Mifepristone/ad [Administration & Dosage]
650			_a*Misoprostol/ad [Administration & Dosage]
650			_aAdolescent
650			_aAdult
650			_aFemale
650			_aGestational Age
650			_aHumans
650			_aPregnancy
650			_aPregnancy Trimester, Second
650			_aUnited States
650			_aYoung Adult
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology
657			_aJournal Article
700			_aReeves, Matthew F
700			_aYe, Peggy P
790			_aCasey FE, Moreno-Ruiz NL, Perritt JD, Reeves MF, Ye PP
856			_uhttps://dx.doi.org/10.1016/j.contraception.2016.02.032 _zhttps://dx.doi.org/10.1016/j.contraception.2016.02.032
942			_cART _dArticle
999			_c2724 _d2724