Re: Meta-analysis of 200 or 600 mg mifepristone in association with two prostaglandins for termination of early pregnancy.

摘要

We were surprised by the publication of Lievre and Sitruk-Ware's recent meta-analysis, specifically by then-assertion that the efficacy of 200 mg vs. 600 mg mifepristone with a prostaglandin for early pregnancy termination is unsettled controversy. The effectiveness of medical abortion practice has overtaken the probabilities presented, primarily because the researched regimens are not those used in current practice. Statistical reviews of clinical trials project an approximation of the "real world." Tested in the real world of the Planned Parenthood Federation of America (PPFA), in several hundred thousand patients, a regimen of 200 mg mifepristone and 800 mcg vaginal or buccal misoprostol yields success rates that are higher and ongoing pregnancy rates lower than those achieved in the four studies reviewed by Lievre and Sitruk-Ware.