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Fertil Steril. 2012 Mar;97(3):612-5. doi: 10.1016/j.fertnstert.2011.12.041. Epub 2012 Jan 20.

Pre-emptive effect of ibuprofen versus placebo on pain relief and success rates of medical abortion: a double-blind, randomized, controlled study.

Author information

1
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel.

Abstract

OBJECTIVE:

To determine the efficacy of pre-emptive administration of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen vs. a placebo on pain relief during medical abortion and to evaluate whether NSAIDs interfere with the action of misoprostol.

DESIGN:

Prospective, double-blind, randomized, controlled study.

SETTING:

University-affiliated tertiary hospital.

PATIENT(S):

Sixty-one women who underwent first-trimester termination of pregnancy.

INTERVENTION(S):

Patients received 600 mg mifepristone orally, followed by 400 μg oral misoprostol 2 days later. They were randomized to receive pre-emptively two tablets of 400 mg ibuprofen orally or a placebo, when taking the misoprostol. The patients completed a questionnaire about side effects and pain score and returned for an ultrasound follow-up examination 10-14 days after the medical abortion.

MAIN OUTCOME MEASURE(S):

Significant pain, assessed by the need for additional analgesia, and failure rates, defined by a need for surgical intervention.

RESULT(S):

Pre-emptive ibuprofen treatment was found to be more effective than a placebo in pain prevention, as determined by a significantly lower need for additional analgesia: 11 of 29 (38%) vs. 25 of 32 (78%), respectively. Treatment failure rate was not statistically different between the ibuprofen and placebo groups: 4 of 28 (14.2%) vs. 3 of 31 (9.7%), respectively. History of menstrual pain was predictive for the need of additional analgesia.

CONCLUSION(S):

Pre-emptive use of ibuprofen had a statistically significant beneficial effect on the need for pain relief during a mifepristone and misoprostol regimen for medical abortion. Ibuprofen did not adversely affect the outcome of medical abortion.

CLINICAL TRIAL REGISTRATION NUMBER:

NCT00997074.

[Indexed for MEDLINE]

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