Premium
Sublingual misoprostol for first trimester termination of pregnancy
Author(s) -
Fekih Myriam,
Fathallah Khadija,
Regaya Lassad Ben,
Bouguizane Sassi,
Chaieb Anouar,
Bibi Mohamed,
Khairi Hedi
Publication year - 2010
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.11.008
Subject(s) - misoprostol , medicine , mifepristone , medical abortion , abortion , obstetrics , regimen , randomized controlled trial , sublingual administration , pregnancy , hematocrit , gynecology , anesthesia , surgery , genetics , biology
Objectives To compare blood loss, efficiency, and acceptability of repeated doses of sublingual misoprostol with the standard Tunisian regimen of mifepristone–misoprostol for first trimester medical abortion. Methods A prospective randomized trial of 252 healthy pregnant women requesting medical abortion in the first trimester (up to 56 days). Participants were randomized to receive 200 mg of oral mifepristone followed by 400 µg of oral misoprostol (group 1) or 800 µg of sublingual misoprostol repeated every 4 hours for up to a maximum of 3 doses (group 2). Primary outcome was blood loss assessed by decrease in hematocrit. Results Mean decrease in hematocrit at follow‐up was significantly greater in group 1 than in group 2 (3.65% ± 1.18% vs 2.69% ± 1.89%, respectively; P = 0.02). There was no difference in efficiency rates between groups 1 and 2 (94.5% vs 92.1%; P = 0.7). Comparable proportions of women experiencing at least one adverse effect after misoprostol administration were reported in groups 1 and 2 (81.7% vs 79.4%; P = 0.75). Conclusion Compared with the most widely used regimen in Tunisia (mifepristone–misoprostol), sublingual misoprostol alone induces less blood loss (although not clinically significant); it is less expensive and offers reduced interval time to expulsion.