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Postpartum hemorrhage is the leading cause of maternal death in China. The main factors leading to postpartum hemorrhage are uterine atony, genital tract trauma, placental factors, anemia and coagulation dysfunction. In recent years, due to the adjustment of China′ s birth policy, the average age of pregnant women has gradually increased, and the incidence and severity of postpartum hemorrhage are also on the rise. Medical institutions should identify postpartum hemorrhage according to the actual situation of the parturient, pay attention to the analysis of the causes of postpartum hemorrhage, take timely prevention and effective countermeasures, and then formulate individualized treatment strategies, maintain the stability of maternal hemodynamics, promote uterine contraction, perform appropriate surgical operations and blood infusion, and drugs such as tranexamic acid, recombinant human activating factor Ⅶ and fibrinogen should be used when necessary to improve hemostasis, so that the patients can receive timely and effective treatment, then reduce bleeding-related mortality, and improve the quality of life of patients in the future. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effects of ergometrine maleate combined with misoprostol on coagulation function, hemodynamics and serum nitric oxide (NO) and nitric oxide synthase (NOS) levels in patients with postpartum hemorrhage after cesarean section. 98 patients with postpartum hemorrhage after cesarean section who were treated in our hospital from June 2017 to October 2019 were selected, they were divided into control group (n=49) and study group (n=49) according to envelope drawing method. Patients in control group were given misoprostol, and study group were treated with ergonoxine maleate on the basis of control group. Coagulation function, hemodynamics, clinical indicators, serum NO, NOS levels and adverse reactions were compared between the two groups. The duration of lochia postpartum and hospitalization time in the study group were shorter than those in the control group, and the bleeding within 2 h after delivery and 2~24 h after delivery in the study group were less than those in the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). After treatment, prothrombin time (PT), thromboplastin time (APTT), fibrinogen (FIB), D-Dimer (D-D) levels of the two groups decreased, and the study group was lower than those of the control group(P<0.05). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups decreased after treatment, but the study group was higher than that of the control group (P<0.05), and the heart rate (HR) of the two groups increased after treatment, but the study group was lower than that of the control group (P<0.05). After treatment, serum NO and NOS levels in both groups were decreased, and the study group was lower than the control group (P<0.05). Ergometrine maleate combined with misoprostol in the treatment of postpartum hemorrhage after cesarean section can effectively maintain the hemodynamic stability, reduce the level of serum NO and NOS, and improve the coagulation function and clinical indicators. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the intervention effects of Xinshenghua granules on mifepristone combined with misoprostol for early medical abortion, so as to provide evidence-based reference for clinical early medical abortion. METHODS: The Cochrane Library, Pub Med, EM Base, CNKI, CBM, Wanfang data. base and VIP data. base were retrieved to collect the randomized controlled trial of Xinshenghua granules ( study group) and blank group ( control group) on intervention of mifepristone combined with misoprostol in early medical abortion, the retrieval time was from the establishment of the database to Mar. 2020. Quality of the included literature was evaluated by using the criteria in the Cochrane Handbook guidelines, while Meta-analysis was performed on the included literature by using Rev Man 5.3 software. RESULTS: Totally 15 literature were collected, including 2 513 patients( 1 272 patients in the study group and 1 241 patients in the control group). Meta-analysis showed that, compared with the control group, the treatment regimen in the study group significantly increased patients' complete abortion rate(RR= I. 14,95%CI= 1.11-1. 18,P<0.00001), the normal rate of vaginal bleeding time( <7 d) (RR= 2.19, 95%CI = 1. 34-3. 56,P = 0. 002) and normal rate of vaginal bleeding volume(less than or equal to normal menstrual volume) (RR= 1. 37, 95% CI= 1.30-1. 44, P < 0.00001), shortened the duration of vaginal bleeding ( WMD = - 4. 24, 95%CI=-4.48--4.00,P<0.00001 ), menstrual rehydration time ( WMD= -3. 44,95%CI= -4. 22--2. 65,P<0.00001 ) and the expulsion time of gestational sac( WMD = -2. 48,95%CI= -2. 70--2. 25,P<0. 000 01), the differences were statistically significant. CONCLUSIONS: Xinshenghua granules can effectively improve the effect of early medical abortion of mifepristone combined with misoprostol, increase the rate of complete abortion, shorten the vaginal bleeding time, the menstrual rehydration time and the expulsion time of gestational sac, and reduce the amount of vaginal bleeding. In the future, multi-center, large-sample randomized controlled trials with higher quality and more complete methodology are needed to further verify the intervention effect of Xinshenghua granules on early medical abortion. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the costs of three treatments for missed abortion, and to screen out the cost -minimization treatment. Methods：The patients diagnosed with missed abortion from January 2017 to December 2018 were divided into three groups randomly. Group A (n=513) was treated with vacuum aspiration, Group B (n=328) medical abortion with mifepristone and misoprostol, Group C (n=559) only misoprostol. Costminimization analysis was done. The direct medical costs were recorded and compared among 3 groups, including all tests before operation, termination of early pregnancy failure and the costs of follow-up. Results：There were no surgical complications in 3 groups. There were no significant differences in the duration of bleeding, days to onset of next menses, times and costs of follow-up among 3 groups. The total cost of Group C was least [CNY 2 787.54 (2 474.29, 3 020.46)], and the total cost of Group A was highest [CNY 4 395.13 (4 175.16，4 627.63)]. The total cost of Group B was moderate [CNY 3 506.39 (3 151.22，3 974.91)]. There were significant differences in the groups (Z=908.950，P＜0.001). Conclusions：In those missed abortion patients without surgical complications, the medical treatment with misoprostol without mifepristone may be cheapest if only considering the medical cost. [ABSTRACT FROM AUTHOR]

Objective To observe the clinical effect, labor and pregnancy outcome of cervical ripening in pregnant women with buccal mucosa containing misoprostol. Methods 122 cases of fetal premature rupture of membranes were divided into buccal mucosa containing misoprostol （study group） and oxytocin group （control group） in 61 cases in each group from January 2017 to April 2018 in our hospital. The buccal mucosa containing misoprostol and oxytocin were used to promote cervical ripening， and the cervical maturity， mode of delivery， labor and outcome of pregnancy were compared between the two groups. Results There were statistically significant differences between the two groups in the efficiency of cervical maturation， vaginal delivery rate and stage of labor （P < 0.05） . The study group was smaller than the control group， and there was no statistically significant difference between the two groups in postpartum hemorrhage， fetal distress and neonatal asphyxia（P > 0.05） . Conclusion The use of buccal mucosa-containing misoprostol can improve the efficiency of uterine cervix maturation， improve the success rate of vaginal delivery，shorten the stage of labor，reduce the infection rate， and have higher safety and better effect than oxytocin. [ABSTRACT FROM AUTHOR]

Objective: To study the curative efficacy of Ergosine plus misoprostol in the treatment of Placenta previa and its effects on the serum Reactive oxygen species(ROS), superoxide dismutase(SOD), glutathione peroxidase(gsh-px) levels. Methods: 100 cases of placenta previa patients admitted to our hospital from May 2016 to May 2017 were selected and divided into the observation group(n=52) and the control group(n=48) according to the random grouping method. The control group was treated with misoprostol,while the observation group was treated with ergoxin combined with misoprostol. The clinical efficacy, changes of serum ROS, SOD and GSH-px levels before and after treatment, intraoperative and postoperative blood loss, hemostasis time and incidence of adverse reactions were compared between the two groups. Results: After treatment, the total effective rates of observation group and control group were96.15% and 81.25%, respectively, which was significantly higher in the observation group than that of the control group(P<0.05). The levels of serum ROS, SOD and GSH-px in the two groups were significantly improved compared with those before treatment, and the levels of serum ROS in the observation group were lower than those in the control group, the levels of serum SOD and gsh-px were significantly higher than those in the control group(P<0.05). The intraoperative and postoperative blood loss and hemostasis time in the observation group were significantly lower than those in the control group(P<0.05). The total incidence of adverse reactions in the two groups was 7.69% and 22.92%, respectively, which was significantly lower in the observation group than that of the control group(P>0.05).Conclusion: The efficacy and safety of ergoxin combined with misoprostol in the treatment of placenta previa are significantly better than those of misoprostol alone, which may be related to the effective improvement of serum ROS, SOD and GSH-px levels. [ABSTRACT FROM AUTHOR]

Objective: To establish a high performance liquid chromatography method for the determination of misoprostol in workplace air. Methods: From February to August 2021, the misoprostol in the workplace air was collected by glass fiber filter membrane, and theeluent was separated by C18 liquid chromatography column, determined by UV detector, and quantified by external standard method. Results: The quantitative lower limit of misoprostol determination method was 0.05 μg/ml, and the lowest quantitative concentration was 1.4 μg/m(3) (calculated by collecting 75 L air sample). The concentration of misoprostol has a good linear relationship between 0.05 to 10.00 μg/ml. The relative coefficient was 0.9998. The regression equation of the standard working curve was y=495759x-45257. The range of average recovery rates were from 95.5% to 102.8%. The intra-assay precision of the method was 1.2%-4.6%, and the inter-assay precision was 2.0%-5.9%. The samples could be stored stably for 7 days at 4 ℃. Conclusion: The high performance liquid chromatography method for the determination of misoprostol has high sensitivity, good specificity and simple procedure of sample pretreatment. It is suitable for the detection of misoprostol in the workplace air.

Mifepristone combined with misoprostol has been widely applied in medical abortion for terminating first trimester pregnancy due to its effectiveness, safety and acceptability. However, there are some unfavourable problems, such as incomplete abortion and ongoing pregnancy. Several factors have been found to be related to the clinical outcomes of medical abortion, such as single misoprostol, the insufficient dose of mifepristone or misoprostol, the short interval time of two medicines, oral administration of misoprostol, the increased pregnancy time, the oversized pregnancy sac diameter, the multiple parous history, the history of cesarean section, the uterine anteflexion or retroflexion and the inappropriate intervention. Those factors related to the outcomes of medical abortion, as well as the mechanism, are discussed in this review, which is helpful for the clinic to improve the effectiveness and safety of medical abortion. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of Mifepristone combined with Misoprostol on abortion of scar uterine pregnancies with different characteristics in mid-term. Methods: A retrospective analysis of medical records of 102 patients with scar uterine pregnancies during June 2012 to May 2015 in our hospital, and Student′s t and chi-square test were used to compare the differences of contractions launch time, the discharge time of the gestational sac, vaginal bleeding,miscarriage and degree-related adverse reactions among the patients with different age (<35 years vs. ≥35 years), history of cesarean section (<1 year vs. 1-2 years vs. >2 years) and uterine surgery healing abortion(uniform continuous vs. non-uniform continuous, or weak area vs. no weak area). Results: The discharge time of fetus and its appendages in patients with no weak areas of uterine scar was shorter than that had weak areas of uterine scar (t=-2.57, P=0.01), and the distribution of the degrees of abortion was also significant difference between the patients with weak area and without weak area (χ2=11.92, P<0.01); the total incidence of adverse effects in patients with non-uniform continuous occurrence of uterine healing was significantly higher than that with uterine healing uniform continuity (χ2=6.32, P=0.01). Conclusions: Mifepristone combined with Misoprostol was efficient for abortion of scar uterine pregnancies in mid-term that effected by the recovery of the uterus, and patients with weak area in uterine scar and non-uniform continuous occurrence of uterine healing should be further treated and guardianship. [ABSTRACT FROM AUTHOR]

Objective To compare the effects and safety of dinoprostone（dinoprostone suppositories）and misoprostol respectively combined with oxytocin for promoting cervical ripening and induced labor. Methods One hundred and eighty primiparas receiving the induced labor treatment in the obstetric department of this hospital from July to December 2016 were randomly divided into the three groups，60 cases in each group. The group A was given dinoprostone combined with oxytocin，the group B was given misoprostol combined with oxytocin and the group C used simple oxytocin. Then the cervical Bishop score， induced labor outcomes，adverse events during induced labor process，total hospitalization cost were observed in 3 groups and performed the comparative analysis..Results The time in labor and total labor process in the group A and B were shorter than those in the group C，the difference was statistically significant（P<0.05）；the promoting cervical ripening and occurrence rate of excessive strong uterine contraction in the group A and B were higher than those in the group C，the difference was statistically significant（P<0.05）；the total hospitalization costs in the group C was higher than that in the group A and B，moreover the group A was higher than the group B，the difference was statistically significant（P<0.05）.Conclusion Dinoprostone combined with oxytocin has the highest success rate of induced labor，while oxytocin is most safe for induced labor，and misoprostol combined with oxytocin is most economical and practical for conducting induced labor. [ABSTRACT FROM AUTHOR]

Objectives: To investigate influencing factors of intrapartum fever during vaginal delivery and to construct a prediction model for infectious intrapartum fever., Methods: A total of 444 patients with intrapartum fever admitted in Ningbo Women and Children's Hospital from January 2020 to December 2021 were enrolled. The clinical data and laboratory findings were compared between patients with infectious intrapartum fever and non-infectious intrapartum fever, and the factors associated with intrapartum fever were analyzed with a multivariate logistic regression model. A prediction nomogram model was constructed based on the factors of intrapartum fever and its predictive efficiency was evaluated by correction curve and receiver operator characteristic curve., Results: In the 444 cases, 182 (41.0%) had definite intrauterine infection and 262 (59.0%) had no infectious intrapartum fever. Univariate analysis showed that the length of hospital stay before induced labor, the time of induced abortion, misoprostol administration, autoimmune diseases, white blood cell count (WBC) and hypersensitive C-reactive protein (hs-CRP) levels were significantly different between the two groups (all P <0.05). Multivariate analysis showed that misoprostol administration and autoimmune diseases were protective factors ( OR =0.31 and 0.36, both P <0.05) for infectious intrapartum fever, while high WBC and hs-CRP were risk factors ( OR =1.20 and 1.09, both P <0.05). The area under the curve of nomogram model for predicting infectious intrapartum fever was 0.823, and the calibration curve validation showed that the predicted and measured values were in general agreement., Conclusions: Multiple factors cause intrapartum fever. The nomogram model constructed in this study has good predictive accuracy for infectious intrapartum fever.

Objective: To assess the efficacy and side effects of different routes of misoprostol administration for cervical ripening before uterine cavity operation. Methods: The databases of Medline, Embase, the Cochrane Library, CNKI,CBM, Wanfang Data were retrieved to October 2014. According to the inclusion and exclusion criteria,literature was screened and extracted by two researchers independently, and then the quality was reviewed by and treated by using Rev Man 5.2 software. Results: 12 studies with 2 529 participants were included. Evidence was found that there were no statistical differences in cervical diameter, when misoprostol administered orally or sublingually or vaginally were compared in pairs (P＞0.05). Uterine cavity operation time in vaginally administered was less than in the orally (P＜0.05), but there was no significant difference in cervical dilatation time (P＞0.05). And the above two index in sublingually administerd were less than in vaginally (P<0.05). The incidence of nausea and diarrhea were found to be more common in the orally and sublingually administered misoprostol group compared with vaginally administered, and emesis was found to be more common in sublingually administered misoprostol group when comparing with vaginally administered misoprostol group (P＜0.05). In addition, different routes of misoprostol administration were no statistical differences in incidence of side effects including cramping, vaginal bleeding, fever and shivering (P ＞0.05). Conclusions: Misoprostol administered orally or sublingually had similar efficacy in cervical ripening of vaginal misoprostol. In view of avoiding drug related side effects, vaginally route of misoprostol could be considered as an effective medication. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To prepare misoprostol suppository and establish the method of quality control of the suppository. METHODS: The polyethylene glycol was used as the substrate of misoprostol suppository, the Pharmacopoeia of the People’s Republic (2015 Edition) was adopted for qualilyconlrol, content and accumulative dissolution of misoprostol in misoprostol suppository were determined by HPLC. RESULTS; The character, weight variation and dissolution were in line with the standard. The content of misoprostol suppository showed a good linear relationship in 10. 17-35.60 μg/ml, the average standard recovery was (99. 02 ± 1.52)% , with RSD of 0.90%. CONCLUSIONS: This preparation method is easy to operate, the method for quality control was stable and reliable. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the clinical effects and safety of misoprostol for promotion of the ripeness of cervix in late pregnancy. METHODS： 380 patients with termination of pregnancy admitted into Beijing Shunyi District Hospital from Jan. 2015 to Oct. 2015 were selected to be divided into observation group and control group via the random number table, with 190 cases in each. The control group were treated with oxytocin, while the observation group were given misoprostol. The cervical score, stages of labor，early severe epilepsy of two groups were observed，and the incidence of adverse drug reactions were compared between two groups. RESULTS： After administration of 24 h， the cervical Bishop score of observation group was significantly higher than that of control group，with statistically significant difference ( P < 0. 05 ). The total effective rate of observation group was significantly higher than that of control group， with statistically significant difference (P <0. 05). The total stages of labor of observation group was significantly shorter than that of control group，yet the incidence of vaginal delivery was higher than that of control group，with statistically significant difference (P <0. 05). There was no statistical significance between two groups in incidence of adverse drug reactions (P >0. 05) . CONCLUSIONS： The effects of misoprostol for promotion of the ripeness of cervix in late pregnancy is remarkable，with convenient administration，high parturition rate and rapid labor progress. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the application effect of two main methods in induced labor in midtrimester pregnancy of cicatricial uterus. Two methods were the Mifepristone combined with misoprostol and the mifepristone combined with ethacridine. Methods: We searched MEDLINE, EMBASE, VIP Database, Wanfang Database and CNKI(from inception to Nov. 2013). Randomized controlled trials(RCTs) of induced labor in mid -pregnancy of cicatricial uterus, with methods of the Mifepristone combined with Misoprostol (group A) or the Mifepristone combined with Ethacridine (group B), were reviewed and evaluated. RevMan5.2 software was used for Meta-analysis. Results: Eight literatures were included, and quality of the literatures was based on the Jadad scale scoring criteria. Meta-analysis showed that the group B was significantly superior to the group A in the time of launching uterine contraction (P<0.000 01, WMD=-12.60, 95% CI: -17.17, -8.03) and induction (P=0.000 5, WMD=-10.50, 95% CI: -16.46, -4.55), placental and fetal membrane residues (Z= 3.07, P=0.002, 95% CI:0.37,0.80) and induced labor success rate (Z=2.31, P=0.02, 95% CI:0.19, 0.88), and that there were no significant differences between two groups in the total stage of labor (P=0.10, WMD=-2.16, 95% CI:-4.73, 0.42) and the amount of vaginal bleeding within 24 hours after delivery(P=0.11,WMD=-29.01, 95% CI: -64.12, 6.09). Conclusions: When the induced labor in midtrimester pregnancy of cicatricial uterus was used, the Mifepristone combined with Ethacridine was significantly superior to the Mifepristone combined with Misoprostol in the time of launching uterine contraction, total time of induced labor, placental and fetal membrane residue, and the success rate of induced labor, except the total stage of labor and amount of vaginal bleeding within 24 hours after delivery. [ABSTRACT FROM AUTHOR]

Clinopodium chinense, a traditional folk medicinal herb, has been used to treat abnormal uterine bleeding(AUB) for many years. Saponins and flavonoids are the main active components in C. chinense. To study the pharmacokine-tics of multiple components from the total extract of C. chinense(TEC), we established a sensitive and rapid method of ultra-perfor-mance liquid chromatography coupled with tandem mass spectrometry(UPLC-MS/MS) for simultaneous determination of five compounds in the plasma of AUB rats. After validation, the AUB model was established with SD female rats which got pregnant on the same day by gavage with mifepristone(12.4 mg·kg~(-1)) and misoprostol(130 μg·kg~(-1)). The established method was applied to the detection of hesperidin, naringenin, apigenin, saikosaponin a, and buddlejasaponin Ⅳb in AUB rats after the administration of TEC. The pharmacokinetic parameters were calculated by DAS 2.0. The five compounds showed good linear relationship within the detection range. The specificity, accuracy, precision, recovery, matrix effect, and stability of the method all matched the requirements of biolo-gical sample detection. The above 5 compounds were detected in the plasma of AUB rats after the administration of TEC. The C&#95;(max) va-lues of hesperidin, naringenin, apigenin, saikosaponin a, and clinoposide A were 701.6, 429.5, 860.7, 75.1, and 304.1 ng·mL~(-1), respectively. All the compounds owned short half-life and quick elimination rate in vivo, and the large apparent volume of distribution indicated that they were widely distributed in tissues. Being rapid, accurate, and sensitive, this method is suitable for the pharmacokinetic study of extracts of Chinese herbal medicines and provides a reference for the study of pharmacodynamic material basis of C. chinense in treating AUB.

OBJECTIVE:To probe into the clinical effects of carboprost tromethamine in treatment of postpartum hemorrhage caused by uterine inertia .METHODS:146 patients with postpartum hemorrhage caused by uterine inertia admitted from Feb .2014 to Jun .2015 were selected to be divided into observation group and control group via the random number table , with 73 cases in each .The control group were given conventional therapy , while the observation group additionally received carboprost tromethamine based on the control group .The efficacy, hemostatic time, bleeding volume of postpartum 2h and 24h, falling range of hemoglobin and occurrence of adverse drug reactions were compared between two groups after treatment .RESULTS: The total effective rate of observation group was 95.9%(70/73), significantly higher than that of control group [72.6%(50/73)], with statistically significant difference ( P<0.05 ) .The hemostatic time of observation group was shorter than that of control group , and the bleeding volume of postpartum 2 h and 24 h was less than that of control group , with statistically significant difference ( P<0.05 );and the falling range of hemoglobin of observation group was lower than that of control group , with statistically significant difference ( P<0.05 ) .There were no obvious adverse drug reactions in two groups .CONCLUSIONS: The clinical efficacy of carboprost tromethamine in treatment of postpartum hemorrhage caused by uterine inertia is remarkable , which has high safety and is worthy of clinical application and promotion . [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of Misoprostol in treating postpartum hemorrhage caused by pregnancy-induced hypertension(PIH). Methods: We selected in our hospital 200 cases of PIH pregnant women with postpartum bleeding. They were divided randomly into observation group and control group, 100 patients in each group. After fetal childbirth, patients in control group had intramuscular injection of oxytocin, while patients in observation group had Misoprostol and uterus massage. Compare the average blood loss and blood pressure after treatment between the two groups. Results: The average blood loss before treatment in control group and observation group was respectively(623.2±45.8) mL and(630.0 ± 46.3) mL, P1 = 0.176. After treatment, the average blood loss was respectively(486.1±24.3) m L and(313.3±23.1) mL in control group and observation group. Compared with before treatment,maternal blood loss after treatment was decreased in two groups. The blood loss in observation group was less than in control group(P2 =0.026). The systolic blood pressure and diastolic blood pressure of patients in severe PIH state in control group were(170.1±6.7) mm Hg,(113.2±2.1) mm Hg, those of patients in medium state were(153.6±5.1) mm Hg,(104.5±5.3) mm Hg, and those of patients in mild state were(138.9±4.2) mm Hg,(93.2±2.0) mm Hg, respectively. The systolic blood pressure and diastolic blood pressure of patients in severe PIH state in observation group were(169.2 ±6.5) mm Hg,(114.4 ±2.5) mm Hg, those in medium state were(156.2 ±4.8) mm Hg,(105.9 ±4.9) mm Hg, and those in mild state were(140.2 ±4.4) mm Hg,(90.2 ±4.4) mm Hg, respectively. Under the corresponding condition, there were no statistical differences between two groups(P3=0.87, P4=0.88, P5=0.75, P6=0.83, P7=0.64, P8=0.92). The incidence rates of adverse reactions in control group and observation group were respectively 1.0%(1/100) and 2.0%(2/100), with no statistical difference(P 0.05). Conclusion: Misoprostol is effective, safe and convenient to treat postpartum hemorrhage caused by pregnancy-induced hypertension. It is worthy of further promotion. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of mifepristone and misoprostol combined with early uterine curettage in early pregnancy artificial abortion operation. Methods 659 early pregnant women in our hospital from January 2014 to January 2015 were selected as the research subjects and randomly divided into the observation group (386 cases) and the control group (273 cases). The two groups were given the medication abortion scheme of mifepristone and misoprostol. The observation group was performed the routine uterine curettage at 3 h after taking misoprostol, while whether conducting the uterine curettage in the control group was determined according to the follow up situation. Contemporaneous 256 early pregnant women requiring painless artificial abortion were selected as the painless artificial abortion group. The rate of complete abortion, total cost, vaginal bleeding amount, bleeding time and pain situation caused by curettage operation were compared among 3 groups. Results The complete abortion rate in the observation group was 100%, the amount of vaginal bleeding and bleeding time were obviously reduced compared with the control group, the differences were statistically significant (P<0.05). The needing total cost had no statistical difference between the observation group and the control group (P>0.05); the total cost in the painless artificial abortion group was higher than that in the observation group and the control group, the difference was statistically significant (P<005). The occurrence rates of mild pain and severe pain in the observation group were lower than those in the control group with statistical difference (P<0.05). Conclusion Mifepristone and misoprostol combined with early uterine curettage can increase the complete abortion rate, reduce intraoperative bleeding and bleeding time, moreover the needing cost is reduced, which is suitable for popularization in rural areas. [ABSTRACT FROM AUTHOR]

Objective: To investigate the efficacy and safety of the termination of second trimester pregnancy with mifepristone and misoprostol in patients with previous cesarean section. Methods; 105 women with scarred uterins (group 1) due to previous cesarean and 105 matched patients (group 2) without uterine scar were retrospectively analyzed. They underwent termination of second trimester pregnancy with mifepristone and misoprostol. The success rate of abortion, the induction-to-delivery interval, the occurrence rate of retained placenta, uterine rupture and hemorrhage were compared. Results: There were no significant differences in the abortion rate (96.2% vs. 94.3%), the induction-to-delivery interval (both 5 h) and the retained placenta rate (15.2% vs. 7.6%) between the two groups (P>0.05). There was only one case of uterine rupture in the group 1. Conclusions: Mifepristone combined with misoprostol are safe and effective in the termination of second trimester pregnancy for those patients with scarred uterins. But during the termination of pregnancy, overall evaluation and careful monitoring are necessary. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of misoprostol combined with oxytocin on serum levels of angiotensin II (Ang II) and coagulation factors after parturient postpartum, which is a useful reference for effective treatment of postpartum hemorrhage. Methods: 120 parturients with postpartum hemorrhage from our hospital during Dec 2010 to Jan 2013 were included in this study. Those high-risk factors were pregnancy hypertension, placental abruption, placenta previa, fetal macrosomia and multiple pregnancy. Those cases were randomly divided into three groups, each with 40 cases. Parturients in group A were immediately administrated with misoprostol 400 µg through rectum after baby delivery. Parturients in group B were immediately administrated with oxytocin 20 U through palace intramuscular, at the same time, with oxytocin 20 U through intravenous infusion. Parturients in group C were immediately administrated with oxytocin 20 U through palace intramuscular and misoprostol 400 µg through rectum. The postoperative bleeding volume was measured by volum and weight after postpartum 2 h and 24 h. The serum levels of angiotensin and coagulation factors were measured by ELISA. The systolic pressures before childbirth and post partum were observed. Results :There were not significant differences in the serum levels of Ang E between antepartum and postpartum, in both group A and group B (P<0.05) while this difference was significant in group C (t=7.196, P=0.009). The same status was found in the serum levels of two coagulation factors in three groups. The hemorrhage volumes post partum 2h, 24h of group A and group B were significantly increased than that of group C (P<0.05). The differences of those systolic pressures before childbirth and post partum 2h, in three groups, were not significant (P<0.05). Conclusions: Misoprostol combined with oxytocin can significantly increased serum levels of angiotensin and coagulation factors when to treat effectively postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the clinical effects of mifepristone and misoprostol combined with uterine curettage in treatment of missed abortion. METHODS; 60 patients with missed abortion admitted into Jiangxi Provence Anfu County Maternal and Child Health Hospital from Jul. 2013 to Jul. 2016 were selected to be divided into observation group and control group via the random number table, with 30 cases in each. The eontrol group were given estradiol valerate, uterine curettage was conducted after 3 d. Hie observation group received mifepristone and misoprostol combined with uterine curettage. Ilie treatment effects of two groups were compared. BESULTS; Ilie operative time, vaginal bleeding, pain and the incidence of BASS of the observation group were significantly lower than those of the control group, one-time success rate and the total effective rate of cervical dilatation were significantly higher than those of the control group, with statistically significant difference (P<0.05). CONCLUSIONS; Hie efficacy of mifepristone and misoprostol combined with uterine curettage in treatment of missed abortion is remarkable, which can reduce the incidence of complications. [ABSTRACT FROM AUTHOR]

Objective: To analyze and evaluate the acceptability of mifepristone compatible with misoprostone versus conventional surgical abortion among women under unwanted early pregnancy, so as to help the unexpected pregnant women to choose the satisfactory abortion, and to provide the evidence for clinicians to make a proper clinical decision., Methods: Six medical databases were searched, including MEDLINE, EMBASE, Cochrane library, CBMdisc, CNKI and VIP, together with twelve journals hand-searched, and references of included studies additionally searched. Two qualified reviewers reviewed the original articles, evaluating qualities of articles, and extracting data independently. After heterogeneity test, the data was pooled using Revman software if capable, or descriptive analysis was applied., Results: In total, nine original clinical controlled trials were included, containing 3565 cases. Before abortion, more unwanted pregnant women chose the medical abortion because they believed medical abortion was less painful than surgical abortion (OR = 466.51, 95% CI: 91.37 - 2381.88), but medical abortion was less time-consuming than surgical abortion (OR = 0.02, 95% CI: 0.01 - 0.06). After abortion, satisfaction with medical abortion was similar to that with surgical abortion, with insignificant difference (P = 0.89). However, second choice and recommendation rates of medical abortion were much higher than those of surgical abortion with OR and 95% CI as 2.72, 2.13 - 3.47 and 4.19, 2.16 - 11.16, respectively., Conclusions: Medical abortion was less painful than surgical abortion and the rate of second choice and recommendation to others were all also higher than those of surgical abortion. However, the process of medical abortion was not as quick as surgical abortion but the satifacation of both methods seemed similar. Therefore, the two artificial abortion methods were not recommended to replace each other at the present time.

Objective: To study the effect of total glycoside from Clinopodium polycephalum (Vaniot) C. Y. Wu et Hsuan on uterine bleeding quantity in drug abortion model rats., Method: Mifepristone and misoprostol were given to early-pregnancy rats orally. The change of uterine bleeding quantity was observed in uncompletive abortion model rats., Result: TGCP (20 mg/kg) could markedly reduce uterine bleeding quantity in drug abortion model rats., Conclusion: TGCP has the hemostatic effect on uterine bleeding in drug abortion model rats.

Objective: To investigate the effects of mifepristone on decidua at the cellular level of estrogen receptor (ER) and progesterone receptor (PR) and the mechanism of prolonged uterine bleeding after terminating early pregnancy by mifepristone., Methods: Thirty decidua specimens were obtained from pregnant women with amenorrhea of 6-7 week duration, 20 women were treated with mifepristone and 10 given mifepristone plus misoprostol respectively. Immunocytochemical reactions of PR nad ER in decidua were compared among three groups using computer image analysis technology., Results: In the control group, the nuclei of the decidual cells were stained positively for ER and PR. Their integral values of receptor level were 5,860,790 +/- 311,691 for ER and 4,905,970 +/- 157,319 for PR. Mifepristone treatment reduced ER and PR staining. The integral values were 3,547,180 +/- 191,858 for ER and 3,700,750 +/- 188,322 for PR in this group, and it was more apparent in the group treated with mifepristone plus misoprostol: 2,021,721 +/- 145,281 for ER and 2,528,580 +/- 240,535 for PR., Conclusions: The ER and PR level in human decidua decreased after mifepristone or/and misoprostol treatment. This may be related to prolonged uterine bleeding after terminating early pregnancy by mifepristone.

Objective: To study relationship of decidual and villous cells apoptosis and its control gene B-cell lymphoma/leukemia-2(bcl-2), bcl-2 associated X protein (bax) with medical abortion., Methods: Forty four women who volunteered to terminate their pregnancy were divided into 3 group: mifepristone group (exp. 1, n = 15), mifepristone with misoprostol group (exp. II, n = 14) and control group (n = 15). The cell cycles of DNA of the decidual and villous cells stained with Propidium Iodide (PI) were analyzed and bcl-2 and bax gene protein labeled with immuno-fluorescence were detected by flow cytometry., Results: The percentage of decidual cells apoptosis were (14.0 +/- 3.9)%, (22.9 +/- 6.3)%, (5.3 +/- 9.3)% and of villous apoptosis were (10.9 +/- 2.8)%, (13.9 +/- 4.7)%, (4.6 +/- 3.0)% in exp. I, exp. II and control group respectively. The apoptotic percentages in decidual and villous cells of exp. I and exp. II groups were significantly higher than that of control (P < 0.01-0.001). On DNA histogram, apoptosis peaks appeared in all the groups. The decidual cell apoptosis of exp. II groups was significantly higher than that of exp. I group (P < 0.01). Both decidual apoptotic percentages of exp. I and exp. II groups were significantly higher than that of villous (P < 0.01). Decidual bcl-2/bax ratio were 1.4 +/- 0.7, 0.9 +/- 0.3, 1.4 +/- 0.7 and villous bcl-2/bax ratio were 1.0 +/- 0.4, 0.8 +/- 0.3, 1.4 +/- 0.6 in the 3 groups respectively. Both decidual and villous bcl-2/bax ratio of exp. II group was significantly lower than that of control (P < 0.05-0.01) which was in consistent with apoptosis., Conclusions: These data indicated that mifepristone with misocprostol for terminating human early pregnancy might be realized by inducing decidual and villous cells excessive apoptosis. The descent of bcl-2/bax ratio could be one of the factors of inducing decidual and villous apoptosis.

Objective: To explore the causes of abnormal uterine bleeding following termination of early pregnancy using mifepristone., Methods: 19 specimens were obtained by curettage on the day immediately after expulsion of gestational sac, 40 specimens on the 7th postabortal day and 20 specimens during 2-12 weeks after induced abortion using mifepristone respectively. The histopathologic changes of the specimens were observed by HE staining, and the expression of human choronic gonadotropin (hCG) and human placental lactogen (hPL) by immunohistochemical studies as well as phloxine-tartrazine staining and Gordon Sweets staining., Results: It showed that decidua shedding retarded, especially basal decidua. Immunohistochemical studies demonstrated the trophoblasts were still active and might affect pathological changes of local endometrium. The specific granules of endometrial granulocytes disappeared, together with disintegration of the reticular fibers. But in the group which curettage was indicated for abnormal bleeding 2 weeks after abortion, the main cause was incomplete abortion., Conclusions: In addition to incomplete abortion, the retardation of decidua shedding and the impairment of endometrium regeneration were responsible for the abnormal uterine bleeding following termination of early pregnancy using mifepristone. The incomplete dissolution of the reticular fibers in basal decidua may induce decidua shedding retardation and incomplete abortion.

Objectives: To find out the optimal regimen of mifepristone in combination with misoprostol for termination of 10-16 week's gestation., Methods: A randomized comparative study in 2,007 women requesting medical abortion at 10-16 week's gestation from 24 hospitals was conducted in Shanghai. Women were randomly divided into 4 groups. In group I (n = 511) women took mifepristone 75 mg orally per day for 2 days (total dose 150 mg), and 48 hours later misoprostol 0.6 mg orally every 3-4 hours for 3 times; group II (n = 491) mifepristone 100 mg orally per day for 2 days (total dose 200 mg) and 48 hours later same dose of misoprostol were taken as in group I; group III (n = 519) same dose of mifepristone as in group I and 48 hours later misoprostol given vaginally every 12 hours for 3 times; group IV (n = 486) same dose of mifepristone as in group II and 48 hours later same dose of misoprostol vaginally as in group III., Results: The successful abortion rate from group I to group IV were 88.6%, 89.4%, 90.9% and 94.0% respectively. The successful abortion rate of group IV was higher than that in group I and II with significant differences (P < 0.05). The average dose of misoprostol by vaginal route in successful case was much lower than that by oral (P < 0.01), and the rate of side effects was much lower by vaginal too., Conclusion: Mifepristone taken 200 mg orally plus misoprostol vaginally is an optimal method for termination of 10-16 week's gestation.

Eighty late pregnancy women were randomized into two groups. Misoprostol group and oxytocin group. We observed the different effects of misoprostol and oxytocin on induction, the different effects of misoprostol on induction which was given through rectum or through vagina. The results indicate that the rate of successful induction in misoprostol group is higher than that of oxytocin group, the rate of caesarean section in misoprostol group is lower than that of oxytocin group. There was no significant difference in the durations of misoprostol which was given through rectum or through vagina on induction. It is suggested that misoprostol is more effective on induction than that of oxytocin. We can choose misoprostol given through rectum to prompt delivery in conditions such as premature rupture of membranes and vaginitis.

Objective: To determine the efficacy of mifepristone (RU486) combined with misoprostol as an induction agent for the initiation of labour in women at term., Methods: Our study group contained 68 pregnant women at term (gestational age: 38-41 weeks) who had clear clinical indications for labour induction. They received mifepristone either 150 mg or 200 mg respectively in the first two or three days. The shortening of the cervical length, the change of Bishop score and the change of the blood serum in oestradiol (E2) concentration and progesterone (P) concentration were observed respectively before and after medication. On the fourth day, misoprostol was added from 100 micrograms to 300 micrograms successively. The outcome of labour induction in these women was recorded., Results: The cervical length of women who were given mifepristone was 1-3 cm shorter and Bishop score was 4-5 higher than those before treatment. The E2 concentration and the P concentration were significantly higher and lower respectively than those before treatment. The cervical ripening ratio was 100.00%. The incidence of the onset of labor was 93.00% and the incidence of vaginally delivery was 80.88% after misoproston was given., Conclusion: Mifepristone combined with misoprostol is a safe, efficient, economical and convenient induction agent for initiation of labor in women at term.

Objective: To study the histological changes of uterine cervix during termination of early pregnancy by mifepristone and prostaglandins (PG)., Methods: A total of 24 women who requested medical abortion was recruited. For each woman, 3 cervical biopsies were taken: before mifepristone treatment; 48 hours after mifepristone 150 mg single dose treatment (i.e. immediately before PG administration); and 1 hour after gestational sac expulsion. Specimens were studied by optical and electron microscopy., Results: Significant collagenolysis as demonstrated by marked reduction and irregularity of collagen fibers, abundant accumulation of an amorphorous material of ground substance, and infiltration of neutrophilic polymorphonuclear leukocytes were shown in stroma as well as in the deep portion of cervix after mifepristone as compared to the samples of early pregnant cervix before treatment. These changes presented to a further extent after the expulsion of gestational sac., Conclusion: The changes observed were similar to previous reports during cervical dilatation in term delivery. The present study confirmed the histological cervical ripening effect by mifepristone and suggested it may be used as cervical ripening agent before induction of labor as well.

133 samples of induced early abortions using mifepristone (RU486) in combination with misoprostol (Miso) were examined. There were no significant difference in the outcome and pathological changes between the two groups with varied RU486-Miso dosages. Another 133 samples of abortus (gestational age < or = 49 days) from vacuum aspiration were used as control. The villi of RU486-Miso group showed more extensive and severer degeneration than the villi of the control group under light and electron microscopy. However, whether RU486 affects the trophoblasts directly or in directly is yet in dispute. Further investigation is needed.

Four hundred and fifty pregnant women were recruited for termination of early gestation by mifepristone combined with dl-15-methyl PGF2 alpha or misoprostol. Eight-four out of 450 subjects received curettage because of heavy or prolonged vaginal bleeding and slow decline of urinary hCG levels. Histopathology examinations of specimens obtained during curettage revealed denatured, necrotic and obscure villi and trophoblasts in 77 specimens, which accounted for 91.7%. Among them, 68 samples were mingled with inflammatory cell infiltration, and 15 with decidual cells, only 3 were villi and trophoblasts alone. The remaining 7 specimens were decidua in 6 and inflammatory infiltration in 1, which accounted for 7.1% and 1.2% respectively. This study suggested that the major cause resulting in heavy or prolonged vaginal bleeding after medical abortion by mifepristone and prostaglandin analogue was residual villi and trophoblasts with inflammatory cell infiltration.

Six hundred women in early pregnancy (< 49 days), who requested medical abortion were randomly allocated into 3 groups. In group 1 (n = 301), an initial dose of mifepristone 50 mg was given, followed by 25 mg every 12 hours up to a total dose of 150 mg mifepristone, plus a single oral dose misoprostol 600 micrograms in the morning of the third day. In group 2 (n = 150), the same regimen of mifepristone was given, but dl-15-methyl-PGF2 alpha (PG05) 1 mg vaginal suppository was inserted on the third day. In group 3 (n = 149), a single dose of mifepristone 200 mg was given and misoprostol 600 micrograms was used as in group 1. The complete abortion rate were 95.3%, 97.3% and 95.4% incomplete abortion rate were 3.0%, 2.0% and 2.6% for group 1, 2 and 3, respectively. No significant difference of the two rates was shown among these 3 groups approximate 82% of the women had lower abdominal pain. The overall, occurrence of diarrhea in PG05 group (38.7%) was significantly higher than that in the other 2 groups (21.6 and 20.1%, respectively) (P < 0.001), and so was the occurrence of vomiting. It was concluded that misoprostol, as an orally-effective prostaglandin, in combination with 2 regimens of mifepristone for induced abortion during early pregnancy was as effective as PG05 vaginal suppository. In addition, it has the advantages of convenience for use, less side effects, easy storage and transfer, and low cost.

A clinical trial of misoprostol, an analog of PGE1 produced by G.D. Searle & Co., on treatment of duodenal ulcer was carried out in five hospitals in Beijing, Shanghai, and Guangzhou. Totally 94 cases were treated with misoprostol 200 micrograms q.i.d. for 4 weeks. A parallel comparison was made, using cimetidine 200 mg q.i.d. A double-blind, double-dummy study was conducted. The result showed that the therapeutic efficacy of misoprostol in duodenal ulcer is similar to that of cimetidine. The ulcer healing rate in four weeks being 60.7% and 67.9% respectively, while the overall effectiveness rate being 77.7% and 80.2%. There was no statistically significant difference between the two medication groups. The side effect of misoprostol is mainly mild diarrhea (6.4%), but it disappears despite the continued use of medication. To our impression, misoprostol represents a new therapeutic approach for treatment of peptic ulcer in addition to acid controlling H2 blockers.