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Biomedical subjects

O S Tang

Publications and source records attributed to O S Tang.

24 records · Page 2Linked to original sources

Pilot study on the use of repeated doses of misoprostol in termination of pregnancy at less than 9 weeks of gestation.

Pregnancy was terminated by repeated doses of vaginal misoprostol in 20 women at a gestational age of less than 9 weeks. The women were given 800 microg of vaginal misoprostol as an initial dose followed by 400 microg of vaginal misoprostol every 3 h for 4 doses. Fourteen women (70%, 95% confidence interval: 48 85%) had a complete abortion. Two women (10%) had a missed abortion, and two (10%) had an ongoing pregnancy. Two women ( 10%) had an incomplete abortion. The interval between the first dose of misoprostol and the passage of tissue mass was 25.3 +/- 34.4 h (median: 15 h). The duration of vaginal bleeding was 23.6 +/- 20.4 days (median: 14 days). Side-effects were mild and there was no significant drop in hemoglobin level. Repeated doses of vaginal misoprostol may be an alternative for women who do not want surgical abortion and who live in an area where mifepristone is not available.

Abortifacient Agents, Nonsteroidal↗

A prospective, randomized, double-blind and placebo-controlled study to assess the efficacy of paracervical block in the pain relief during egg collection in IVF.

The role of paracervical block in the pain relief during egg collection in in-vitro fertilization (IVF) is still not confirmed. In this prospective, double-blind and placebo-controlled study, 135 patients undergoing egg collection in their first IVF cycle were randomized to receive 10 ml of 1.5% lignocaine (group A) or normal saline (group B) in the paracervical block and no local injection (group C). No differences were seen among the groups in the demographic data, the ovarian response, the duration of egg collection, the number of follicles punctured, the pregnancy rates and the pain levels related to blood taking, scanning and insertion of an i.v. cannula. All patients experienced similar pain scores for vaginal puncture but patients in group A experienced significantly less abdominal pain during egg collection, compared with those in group B and group C (P = 0.009 and P = 0.001 respectively; Mann-Whitney U-test). When lignocaine was used, the abdominal pain scores were reduced by 38.9 and 51.4% compared with placebo and no local injection respectively. We recommend that paracervical block with lignocaine should be used in conjunction with i.v. sedation/analgesia during egg collection performed through the transvaginal route under ultrasound guidance (TUGOR) to reduce the pain of the procedure.

Abdominal Pain↗

A randomized double-blind placebo-controlled study to assess the effect of oral contraceptive pills on the outcome of medical abortion with mifepristone and misoprostol.

This was a randomized double-blind placebo-controlled trial to determine the effect of oral contraceptive (OC) pills taken immediately after medical abortion on the duration of bleeding and complete abortion rate. Two hundred women in the first 49 days of pregnancy were given 200 mg mifepristone orally followed by 400 microg misoprostol vaginally 48 h later. One day later, they were randomized to receive either OC pills (30 microg of ethinyl oestradiol and 0.15 mg of levonorgestrel per tablet) or placebo for 21 days. The complete abortion rates were 98% in the OC group and 99% in the placebo group. The median duration of bleeding was similar: 17 (range: 5-57) days in the OC group and 16 (range: 6-55) days in the placebo group. In the OC group there was a small but significant fall in the haemoglobin concentration by 14 days (5.3 g/dl) after administration of mifepristone. The incidence of side-effects was similar in the two groups. We conclude that the use of OC pills does not decrease the duration of bleeding after medical abortion nor does it affect the abortion rate.

Abortifacient Agents, Steroidal↗

The use of misoprostol for pre-operative cervical dilatation prior to vacuum aspiration: a randomized trial.

Misoprostol is effective for cervical priming prior to vacuum aspiration for first trimester termination of pregnancy. Previous studies showed that the oral route was more acceptable to patients but there were higher incidences of side-effects when compared with the vaginal route. This study is to determine the optimal dosage and route of administration of misoprostol for pre-operative cervical dilatation. A double-blind, randomized trial was undertaken for 225 nulliparous women with 8-12 weeks amenorrhoea. They were randomly assigned to groups given 0 (placebo), 200 or 400 microg oral or vaginal misoprostol 3 h prior to vacuum aspiration. In misoprostol-treated groups the baseline cervical dilatation was significantly increased when compared with the placebo group; the effect was dose-related in the oral but not in the vaginal group. The cumulative force and blood loss was significantly decreased in the misoprostol-treated groups. The incidences of side-effects were more frequent in misoprostol groups but were not related to the route and dosage of medication. The duration of procedure, incidences of post-operative complications, the duration of post-operative bleeding and the interval to the first period were similar in the five treatment groups. We conclude that a 3 h pre-treatment interval is effective for both oral and vaginal routes. When given orally, 400 microg is more effective than 200 microg. The efficacy was otherwise similar when compared with the vaginal route. We recommend 400 microg oral misoprostol 3 h prior to vacuum aspiration for cervical dilatation.

Abortifacient Agents, Nonsteroidal↗

Pilot study on the use of a two-week course of oral misoprostol in patients after termination of pregnancy with mifepristone and misoprostol.

Twenty women who requested early first trimester termination of pregnancy were recruited to study the tolerability of a 2-week course of oral misoprostol after termination of pregnancy by mifepristone and vaginal misoprostol. Ten patients (50%) complained of mild diarrhea during the 2-week course of misoprostol. Otherwise, there were no other significant side effects. The 2-week course of misoprostol was well tolerated by women who underwent early first trimester termination of pregnancy with mifepristone and misoprostol.

Abortifacient Agents, Nonsteroidal↗

Oral misoprostol versus placebo for cervical dilatation before vacuum aspiration in first trimester pregnancy.

Intravaginal misoprostol has been shown to be effective for cervical priming before a surgically induced abortion. The objective was to investigate the effectiveness of oral misoprostol in cervical dilatation prior to vacuum aspiration between the 6th and 12th weeks of pregnancy. The results showed that in nulliparous patients, the median cervical dilatation in the treatment group (7.8 mm) was significantly greater than that in the placebo group (3.7 mm). In multiparous patients, the difference was also statistically significant (9.8 versus 6.0 mm). The ease of dilatation, assessed subjectively by the operating surgeons, was significantly improved in the treatment group. There was also a significant reduction in the duration of the operation and in the mean blood loss in the treatment group. The side-effects encountered in the treatment group were mild and well accepted by the women. Oral misoprostol is an effective and safe method for cervical dilatation prior to vacuum aspiration in first trimester pregnancy.

Abortion, Induced↗