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Sublingual versus vaginal misoprostol for the management of missed abortion
Author(s) -
Tanha Fateme Davari,
Feizi Mohadeseh,
Shariat Mamak
Publication year - 2010
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01229.x
Subject(s) - medicine , misoprostol , sublingual administration , abortion , vaginal bleeding , obstetrics , randomized controlled trial , adverse effect , pregnancy , diarrhea , anesthesia , surgery , genetics , biology
Abstract Aim: To evaluate the efficacy of two routes of misoprostol administration (sublingual and vaginal) for the treatment of missed abortion. Methods: Two hundred and twenty women with confirmed missed abortion who received 400 µg/6 h misoprostol either sublingually or vaginally, were included in this randomized control trial. All women were admitted to hospital for follow‐up care for 2 days. If the pregnancy was not completely evacuated during this time, the patient underwent immediate surgical completion. Efficacy was defined as the percentage of women discharged from the study without the need for surgical intervention. Results: The effectiveness was high in the sublingual group and statistically different (sublingual 84.5%, vaginal 46.4% P = 0.000 RR = 0.54 95%CI = 0.442–0.681). The groups differed in terms of complications like bleeding (88.2% vs 65.5%), pain (85.5% vs 56.4%), diarrhea (69.1% vs 36.4%) and fever (23.6% vs 13.3%) in the sublingual group versus the vaginal group, but the mean time to expulsion was shorter (9.68 h SD = 5.51 95%CI = 8.61–10.57) in the sublingual group than the vaginal group (16.64 h SD = 14.01 95%CI = 13.8–19.48), P = 0.000. Women in the sublingual group were highly satisfied with the method. Conclusion: Sublingual misoprostol for the medical management of missed abortion is more effective and more acceptable than the vaginal route. However, it showed more adverse effects.