Article type
Year
Abstract
Objectives: It is reported by WHO that about 150 thousand cases were requested for induced abortion every day, or 53 million for each year. Tietzec estimated that about one-third to half of women around the world would experience at least one induced abortion before menopausal period. At present, induced abortion was performed by operation or drugs. However, no data were found in terms of the use of the two methods for induced abortion.
This article is to assess mifepristone and misoprostol in terms of effectiveness, safety and health economics, as well as provide evidences for decision-making at the level of both government and consumers.
Methods: Meta-analysis, Systematic Review and Randomised Controlled Trials(RCTs) about mifepristone and misoprostol for induced abortions were collected by searching Medline, Embase, Cochrane Library, CBM(Chinese Biological Literature Database) and two websites (Guidelines.com and agatha.york.uk), together with hand-searching eight Chinese journals. The study quality was assessed by two independent reviewers using the Jadad Scale plus allocation concealment.
Results: Mifepristone and misoprostol are the most commonly administrated drugs for induced abortion. In terms of effectiveness, 201 RCTs or meta-analysis related to mifepristone and 195 to misoprostol were identified. 194 studies of mifepristone adverse effects and 156 of misoprostol were collected. In studies of mifepristone, women also suffered complications from haemorrhage, cervical laceration, uterine perforation and incomplete abortion, in addition to hypovolemic shock, allergic shock, malignant trophoblastic tumor and epilepsy violent metaldisorder. In studies where misoprostol has been used to induce abortion, hypovolemic shock, allergic shock and new-born malformation (was this where the drug was ineffective in inducing abortion and the pregnancy went to term?) have been the complications. No RCTs or Meta-analysis for cost-effectiveness were identified.
Conclusion: Based on the research and from a clinical perspective, the drug side effects should be evaluated and then the effectiveness of mifepristone and misoprostol should be assessed. There should also be pilot studies of the cost-effectiveness of drug-induced and operation-induced abortion. Further studies are currently underway which will answer these questions.
This article is to assess mifepristone and misoprostol in terms of effectiveness, safety and health economics, as well as provide evidences for decision-making at the level of both government and consumers.
Methods: Meta-analysis, Systematic Review and Randomised Controlled Trials(RCTs) about mifepristone and misoprostol for induced abortions were collected by searching Medline, Embase, Cochrane Library, CBM(Chinese Biological Literature Database) and two websites (Guidelines.com and agatha.york.uk), together with hand-searching eight Chinese journals. The study quality was assessed by two independent reviewers using the Jadad Scale plus allocation concealment.
Results: Mifepristone and misoprostol are the most commonly administrated drugs for induced abortion. In terms of effectiveness, 201 RCTs or meta-analysis related to mifepristone and 195 to misoprostol were identified. 194 studies of mifepristone adverse effects and 156 of misoprostol were collected. In studies of mifepristone, women also suffered complications from haemorrhage, cervical laceration, uterine perforation and incomplete abortion, in addition to hypovolemic shock, allergic shock, malignant trophoblastic tumor and epilepsy violent metaldisorder. In studies where misoprostol has been used to induce abortion, hypovolemic shock, allergic shock and new-born malformation (was this where the drug was ineffective in inducing abortion and the pregnancy went to term?) have been the complications. No RCTs or Meta-analysis for cost-effectiveness were identified.
Conclusion: Based on the research and from a clinical perspective, the drug side effects should be evaluated and then the effectiveness of mifepristone and misoprostol should be assessed. There should also be pilot studies of the cost-effectiveness of drug-induced and operation-induced abortion. Further studies are currently underway which will answer these questions.