***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives To compare the efficacy of two different regimens of mifepristone followed by misoprostol for medical abortion in women with menstrual delay of ≤ 35 days OBJECTIVE To examine the clinical efficacy of mifepristone 100 mg followed 2 days later by misoprostol 400 μg orally or 800 μg vaginally in women at up to 49 days ' gestation . METHODS Eighty participants received mifepristone 100 mg and then were r and omized to misoprostol , administered 48 hours later , at a dose of 400 μg orally ( group 1 ) or 800 μg vaginally ( group 2 ) . Women returned for follow‐up evaluations 24 ± 1 hour after using the misoprostol and then 2–3 weeks later . If abortion still had not occurred and the pregnancy was nonviable , the subject returned again after an additional 3 weeks . RESULTS Twenty‐four hours after receiving misoprostol , 34 ( 85 % ; 95 % confidence interval [ CI ] 71 % , 94 % ) of the 40 women in group 1 and 38 ( 95 % ; 95 % CI 85 % , 99 % ) of the 40 women in group 2 had complete abortions . Overall , complete abortion without surgical intervention occurred in 34 women in group 1 ( 85 % ; 95 % CI 71 % , 94 % ) and 40 women in group 2 ( 100 % ; 95 % CI 91 % , 100 % ; P = .03 ) . Four women in group 1 required suction aspiration for continuing pregnancy at the second follow‐up , compared with none in group 2 ( P = .12 ) . Side effects occurred with similar frequency in both treatment groups . CONCLUSION Low‐dose mifepristone ( 100 mg ) combined with vaginal misoprostol 800 μg may be an effective alternative to regimens using 200 or 600 mg of mifepristone with misoprostol Two doses , 200 and 400 micrograms , of misoprostol , administered vaginally every 12 hours , up to four times , were tested in 101 and 133 healthy women , respectively , for interruption of pregnancies with 35 through 77 days of amenorrhea . The proportion of women who aborted increased with longer duration of treatment and was significantly higher with 400 than with 200 micrograms ( 66 versus 46 percent at 48 hours ) . Significance was maintained after controlling by age , body weight , parity , previous abortion and gestational age . Abortions were classified as incomplete or complete , according to the presence or not of embryonic tissue in the uterine cavity , diagnosed by vaginal sonography . Vacuum aspiration was carried out in all cases not classified as complete abortion 48 hours after the initiation of treatment , or earlier in case of persistent bleeding or woman 's request . The possibility of increasing effectiveness by using higher dose , shorter intervals or longer duration of treatment is discussed Objectives To compare the efficacy of oral and vaginal administration of misoprostol after a single oral dose of 200 mg of mifepristone and to investigate whether the efficacy can be improved and the duration of bleeding shortened by continuing oral misoprostol for one week The purpose of this study was to compare tamoxifen to methotrexate , with respect to effectiveness , when followed by misoprostol to induce abortion . In the first phase , 198 women presenting for medical abortion at < 7 weeks gestation were r and omized to receive either 40 mg of tamoxifen , followed 2 to 3 days later by 800 micrograms of misoprostol self-administered vaginally or 50 mg/m2 of methotrexate , followed 5 to 7 days later by the same dose of misoprostol . In the second phase , 200 women were r and omized to receive 20 mg tamoxifen twice daily for 4 days , followed by 800 micrograms misoprostol or the same regimen of methotrexate and misoprostol as in phase 1 . The main outcome measure was success rate determined by the number of women who aborted without surgery . In phase 1 , the success rate was higher in the methotrexate group ( 93.0 % ) compared to the tamoxifen group ( 85.7 % ) ( p = 0.045 ) . In the tamoxifen group , nine of 98 women had incomplete abortions with symptoms requiring a surgical aspiration , compared to one of 100 women in the methotrexate group . In phase 2 , the success rates were 90.9 % in the methotrexate group compared to 84.7 % in the tamoxifen group ( p = 0.20 ) . The side effects were less in the tamoxifen group in phase 1 but not in phase 2 . When tamoxifen is given as a single dose , it is less effective than methotrexate but when it is given 20 mg twice daily for 4 days , there is no significant difference . Tamoxifen does not appear to have any benefits over methotrexate OBJECTIVE To compare the efficacy and side-effects of mifepristone 75 mg in capsule form versus 150 mg in tablet form followed by misoprostol for medical termination of early pregnancy . STUDY DESIGN In a prospect i ve r and omized , double-blind , placebo-controlled trial , a total of 480 women who were 49 days or less pregnant were r and omized by means of a r and om number table to receive either two tablets in the morning and one tablet 12 h later for 2 days ( group A ) or three capsules orally twice daily for 2 days , the first dose being double all subsequent doses ( group B ) . After a further 48 h , 600 microg misoprostol was given orally . Successful abortion was defined as complete abortion with no need for surgical aspiration . RESULTS There were no significant differences between the two study groups in the rates of complete abortion ( 95.4 % in group A versus 96.3 % in group B ) , incomplete abortion ( 3.8 % in group A , 3.3 % in group B ) and continued pregnancy ( 0.8 % in group A , 0.4 % in group B ) . No significant difference in the duration and amount of vaginal bleeding was observed . The incidence of side-effects , such as vomiting , nausea , headache , diarrhea and lower abdominal pain was similar in the two groups . CONCLUSIONS Our results indicate that 75 mg mifepristone in capsule form combined with 600 microg misoprostol is as effective and safe as 150 mg mifepristone in tablet form for the termination of pregnancy up to 49 days OBJECTIVE Our purpose was to determine whether vaginal misoprostol 7 days rather than 3 days after methotrexate injection increases the percent of successful abortions on the day of misoprostol administration . STUDY DESIGN A r and omized controlled trial was performed in women requesting an abortion at < or = 56 days ' gestation . Eighty-six women were treated with methotrexate 50 mg/m2 intramuscularly followed 3 days ( group 1 ) or 7 days ( group 2 ) later by vaginal misoprostol 800 micrograms . The misoprostol dose was repeated if the abortion did not occur . RESULTS Complete abortion occurred in 38 of 46 ( 83 % ) patients in group 1 and 39 of 40 ( 98 % ) in group 2 ( p = 0.033 ) . Of the women with complete abortions , 30 of 46 ( 65 % ) in group 1 and 27 of 40 ( 68 % ) in group 2 aborted the same day as the first or second dose of misoprostol ( p = 0.823 ) . Vaginal bleeding lasted 14 + /- 5 ( mean + /- SD ) days in group 1 and 17 + /- 9 days in group 2 . The remaining women aborted after a delay of 24 + /- 6 days in group 1 and 28 + /- 13 days in group 2 . For these women vaginal bleeding lasted 18 + /- 17 and 14 + /- 7 days , respectively , and the human chorionic gonadotropin-beta level was < or = 25 IU/L by 22 + /- 7 days after the abortion in group 1 and 19 + /- 9 days in group 2 . Treatment failures in group 1 were four continuing pregnancies ( 9 % ) , two incomplete abortions ( 4 % ) , and two women who requested surgical termination after receiving both medications ( 4 % ) . The treatment failure in group 2 was an incomplete abortion . Methotrexate and misoprostol side effects were infrequent . CONCLUSIONS Methotrexate and vaginal misoprostol are more effective abortifacients when the misoprostol is given 7 days rather than 3 days after methotrexate . This treatment regimen may offer an alternative to surgical abortion or the use of antiprogestins and prostagl and in for medical abortion OBJECTIVE We investigated safety , efficacy , and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries . STUDY DESIGN Women ( n = 1373 ) with amenorrhea < or = 56 days chose either surgical abortion ( as provided routinely ) or 600 mg of mifepristone followed after 48 hours by 400 micrograms of misoprostol . This is the appropriate design for study ing safety , efficacy , and acceptability among women selecting medical abortion over available surgical services . RESULTS The medical regimen had more side effects , particularly bleeding , than did surgical abortion but very few serious side effects . Failure rates for medical abortion , although low , exceeded those for surgical abortion : 8.6 % versus 0.4 % ( China ) , 16.0 % versus 4.0 % ( Cuba ) , and 5.2 % versus 0 % ( India ) . Nearly half of failures among medical clients were not true drug failures , however , but surgical interventions not medically necessary ( acceptability failures or misdiagnoses ) . Women were satisfied with either method , but more preferred medical abortion . CONCLUSION Medical abortion can be safe , efficacious , and acceptable in developing countries Objective To examine the clinical efficacy of mifepristone 600 mg followed on the same day or two days later by misoprostol 400μg orally in women undergoing medical termination of pregnancy whose pregnancies have a gestational age up to 49 days OBJECTIVE : To study the efficacy , safety , and acceptability of oral immediately swallowed and buccal misoprostol 800 mcg after mifepristone 200 mg for terminating pregnancy through 63 days since the last menstrual period ( LMP ) . METHODS : This seven-site study r and omly assigned 966 women seeking abortions to oral or buccal misoprostol 800 mcg 24–36 hours after mifepristone 200 mg with 7–14-day follow-up . RESULTS : Success rates in the oral and buccal groups were 91.3 % ( 389 of 426 ) and 96.2 % ( 405 of 421 ) , respectively ( P=.003 ; relative risk [ RR ] 0.95 , 95 % confidence interval [ CI ] 0.92–0.98 ) . Ongoing pregnancy occurred in 3.5 % ( 15 of 426 ) of women who took oral misoprostol compared with 1.0 % ( 4 of 421 ) of women in the buccal group ( P=.012 ; RR 3.71 , 95 % CI 1.24–11.07 ) . Through 49 days since the LMP , oral and buccal regimens performed similarly , but success with oral misoprostol  decreased as pregnancy advanced . In pregnancies of 57–63 days since the LMP , success with oral misoprostol  fell below 90 % , whereas that with buccal remained high ( oral 85.1 % [ 97 of 114 ] , buccal 94.8 % [ 109 of 115 ] , P=.015 , RR 0.90 , 95 % CI 0.82–0.98 ) . Furthermore , in this gestational age group , there were significantly more ongoing pregnancies among women who took misoprostol orally ( 7.9 % [ 9 of 114 ] ) compared with buccally ( 1.7 % [ 2 of 115 ] ; P=.029 , RR 4.54 , 95 % CI 1.0–20.55 ) . Adverse effect profiles were similar , although fever and chills were reported approximately 10 % more often among women who took buccal misoprostol .  Satisfaction and acceptability were high for both methods . CONCLUSION : Buccal misoprostol 800 mcg after mifepristone 200 mg is a good option for medical abortion through 63 days since the LMP . Oral misoprostol 800 mcg is also a safe and effective alternative , although success rates diminish with increasing gestational age . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT0 
    Output:
    
Misoprostol administered orally is less effective ( more failures ) than the vaginal route ( RR 3.00 , 95 % CI 1.44 to 6.24 ) and may be associated with more frequent side effects such as nausea and diarrhoea .
5 ) There was no difference in effectiveness with use of a divided dose compared to a single dose of prostagl and in .
Safe and effective medical abortion methods are available .
Combined regimens are more effective than single agents .
In the combined regimen , the dose of mifepristone can be lowered to 200 mg without significantly decreasing the method effectiveness .
Vaginal misoprostol is more effective than oral administration , and has less side effects than sublingual or buccal .