Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days

BACKGROUND: From 2001 to March 2006, Planned Parenthood Federation of America (Planned Parenthood) health centers throughout the United States provided medical abortions principally by a regimen of oral mifepristone, followed 24-48 h later by vaginal misoprostol. In late March 2006, analyses of serious uterine infections following medical abortions led Planned Parenthood to change the route of misoprostol administration and to employ additional measures to minimize subsequent serious uterine infections. In August 2006, we conducted an extensive audit of medical abortions with the new buccal misoprostol regimen so that patients could be given accurate information about the success rate of the new regimen. OBJECTIVES: We sought to evaluate the effectiveness of the buccal medical abortion regimen and to examine correlates of its success during routine service delivery. METHODS: In 2006, audits were conducted in 10 large urban service points to estimate the success rates of the buccal regimen. Success was defined as medical abortion without vacuum aspiration. These audits also permitted estimates of success rates with oral misoprostol following mifepristone in a subset in which 98% of the subjects stemmed from two sites. RESULTS: The effectiveness of the buccal misoprostol-mifepristone regimen was 98.3% for women with gestational ages below 60 days. The oral misoprostol-mifepristone regimen, used by 278 women with a gestational age below 50 days, had a success rate of 96.8%. CONCLUSION: In conjunction with 200 mg of mifepristone, use of 800 mcg of buccal misoprostol up to 59 days of gestation is as effective as the use of 800 mcg of vaginal misoprostol up to 63 days of gestation.

Petrology and geochemistry at DSDP Site 59-448

This chemical and petrologic study of rocks from Site 448 on the Palau-Kyushu Ridge is designed to answer some fundamental questions concerning the volcanic origin of remnant island arcs. According to the reconstruction of the Western Pacific prior to about 45 m.y. ago (Hilde et al., 1977), the site of the Palau-Kyushu Ridge was a major transform fault. From a synthesis of existing geological and geophysical data (R. Scott et al., this volume), it appears that the ridge originated by subduction of the Pacific plate under the West Philippine Basin. Thus the Palau-Kyushu Ridge should be a prime example of both initial volcanism of an incipient arc formed by interaction of oceanic lithospheric plates and remnant-arc volcanic evolution. The Palau-Kyushu Ridge was an active island arc from about 42 to 30 m.y. ago, after which initiation of back-arc spreading formed the Parece Vela Basin (R. Scott et al., this volume; Karig, 1975a). This spreading left the western portion of the ridge as a remnant arc that separates the West Philippine Basin from the Parece Vela Basin. In spite of numerous oceanographic expeditions to the Philippine Sea, including the two previous DSDP Legs 6 and 31 (Fischer, Heezen et al., 1971; Karig, Ingle et al., 1975), and even though the origins of inter-arc basins have been linked by various hypotheses to that of remnant island arcs (Karig, 1971, 1972, 1975a, and 1975b; Gill, 1976; Uyeda and Ben-Avraham, 1972; Hilde et al., 1977), very little hard data are available on inactive remnant arcs.