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Mifepristone (RU 486) compared with high-dose estrogen and progestogen for emergency postcoital contraception.
N Engl J Med. 1992 Oct 08; 327(15):1041-4.NEJM

Abstract

BACKGROUND

Mifepristone (RU 486) is a synthetic steroid with potent antiprogestational and antiglucocorticoid properties that provides an effective medical method of inducing abortion in early pregnancy. Since progesterone is essential for implantation, we tested the use of mifepristone for emergency postcoital contraception.

METHODS

We studied 800 women and adolescents requesting emergency postcoital contraception who had had unprotected intercourse within the preceding 72 hours. A total of 398 women and adolescents were randomly assigned to treatment with 100 micrograms of ethinyl estradiol and 1 mg of norgestrel, each given twice 12 hours apart (standard therapy), and 402 women and adolescents were randomly assigned to receive 600 mg of mifepristone.

RESULTS

None of the women and adolescents who received mifepristone became pregnant, as compared with four of those who received standard therapy; the difference in failure rates between the two regimens was not statistically significant. The number of pregnancies in each group was significantly lower than the number expected according to calculations based on the day of the cycle during which intercourse had taken place (P less than 0.001). In many subjects the stage of the cycle as calculated by menstrual history was inconsistent with measurements of plasma progesterone or urinary pregnanediol excretion. The subjects treated with mifepristone reported less nausea (40 percent vs. 60 percent) and vomiting (3 percent vs. 17 percent) on the day of treatment, as well as lower rates of other side effects, than the subjects treated with the standard regimen, but they were more likely to have a delay in the onset of the next menstrual period (42 percent vs. 13 percent).

CONCLUSIONS

Mifepristone is a highly effective postcoital contraceptive agent that, if used more widely, could help reduce the number of unplanned and unwanted pregnancies.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, University of Edinburgh, Scotland, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1522839

Citation

Glasier, A, et al. "Mifepristone (RU 486) Compared With High-dose Estrogen and Progestogen for Emergency Postcoital Contraception." The New England Journal of Medicine, vol. 327, no. 15, 1992, pp. 1041-4.
Glasier A, Thong KJ, Dewar M, et al. Mifepristone (RU 486) compared with high-dose estrogen and progestogen for emergency postcoital contraception. N Engl J Med. 1992;327(15):1041-4.
Glasier, A., Thong, K. J., Dewar, M., Mackie, M., & Baird, D. T. (1992). Mifepristone (RU 486) compared with high-dose estrogen and progestogen for emergency postcoital contraception. The New England Journal of Medicine, 327(15), 1041-4.
Glasier A, et al. Mifepristone (RU 486) Compared With High-dose Estrogen and Progestogen for Emergency Postcoital Contraception. N Engl J Med. 1992 Oct 8;327(15):1041-4. PubMed PMID: 1522839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mifepristone (RU 486) compared with high-dose estrogen and progestogen for emergency postcoital contraception. AU - Glasier,A, AU - Thong,K J, AU - Dewar,M, AU - Mackie,M, AU - Baird,D T, PY - 1992/10/8/pubmed PY - 1992/10/8/medline PY - 1992/10/8/entrez KW - Biology KW - Contraception KW - Contraception Failure KW - Contraceptive Agents KW - Contraceptive Agents, Estrogen--administraction and dosage KW - Contraceptive Agents, Female KW - Contraceptive Agents, Female--administraction and dosage KW - Contraceptive Agents, Postcoital KW - Contraceptive Agents, Progestin--administraction and dosage KW - Contraceptive Agents--administraction and dosage KW - Contraceptive Effectiveness KW - Contraceptive Usage KW - Data Collection KW - Demographic Factors KW - Endocrine System KW - Ethinyl Estradiol--administraction and dosage KW - Examinations And Diagnoses KW - Family Planning KW - Fertility KW - Fertility Measurements KW - Hormone Antagonists KW - Hormones KW - Laboratory Examinations And Diagnoses KW - Norgestrel--administraction and dosage KW - Physiology KW - Population KW - Population Dynamics KW - Pregnancy Rate KW - Research Methodology KW - Ru-486--administraction and dosage KW - Ru-486--side effects SP - 1041 EP - 4 JF - The New England journal of medicine JO - N Engl J Med VL - 327 IS - 15 N2 - BACKGROUND: Mifepristone (RU 486) is a synthetic steroid with potent antiprogestational and antiglucocorticoid properties that provides an effective medical method of inducing abortion in early pregnancy. Since progesterone is essential for implantation, we tested the use of mifepristone for emergency postcoital contraception. METHODS: We studied 800 women and adolescents requesting emergency postcoital contraception who had had unprotected intercourse within the preceding 72 hours. A total of 398 women and adolescents were randomly assigned to treatment with 100 micrograms of ethinyl estradiol and 1 mg of norgestrel, each given twice 12 hours apart (standard therapy), and 402 women and adolescents were randomly assigned to receive 600 mg of mifepristone. RESULTS: None of the women and adolescents who received mifepristone became pregnant, as compared with four of those who received standard therapy; the difference in failure rates between the two regimens was not statistically significant. The number of pregnancies in each group was significantly lower than the number expected according to calculations based on the day of the cycle during which intercourse had taken place (P less than 0.001). In many subjects the stage of the cycle as calculated by menstrual history was inconsistent with measurements of plasma progesterone or urinary pregnanediol excretion. The subjects treated with mifepristone reported less nausea (40 percent vs. 60 percent) and vomiting (3 percent vs. 17 percent) on the day of treatment, as well as lower rates of other side effects, than the subjects treated with the standard regimen, but they were more likely to have a delay in the onset of the next menstrual period (42 percent vs. 13 percent). CONCLUSIONS: Mifepristone is a highly effective postcoital contraceptive agent that, if used more widely, could help reduce the number of unplanned and unwanted pregnancies. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/1522839/Mifepristone__RU_486__compared_with_high_dose_estrogen_and_progestogen_for_emergency_postcoital_contraception_ L2 - https://www.nejm.org/doi/10.1056/NEJM199210083271501?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -