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A prospective randomised comparison of sublingual and vaginal misoprostol in second trimester termination of pregnancy
Author(s) -
Tang Oi Shan,
Lau Winnie Nga Ting,
Chan Carina Chi Wai,
Ho Pak Chung
Publication year - 2004
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00222.x
Subject(s) - misoprostol , medicine , obstetrics , pregnancy , second trimester , prospective cohort study , gestation , abortion , surgery , genetics , biology
Objective To compare the efficacy, side effects and acceptability of sublingual and vaginal misoprostol for second trimester medical abortion. Design Prospective randomised controlled trial. Setting Tertiary referral unit and a teaching hospital. Population Two hundred and twenty‐four women at 12 to 20 weeks of gestation. Methods The women were randomised to receive either sublingual or vaginal misoprostol 400 μg every 3 hours for a maximum of five doses. The course of misoprostol was repeated if the woman did not abort within 24 hours. Main outcome measures The success rate at 48 hours, induction‐to‐abortion interval and the side effects. Results There was no significant difference in the success rate at 48 hours (sublingual: 91%; vaginal: 95%). However, the success rate at 24 hours was significantly higher in the vaginal group (85%) compared with the sublingual group (64%). There was no difference in the median induction‐to‐abortion interval (sublingual: 13.8 hours; vaginal: 12.0 hours). Significantly more women in the sublingual group preferred the route to which they were assigned when compared with the vaginal group. The incidence of fever was also less in the sublingual group. Conclusion The use of vaginal misoprostol for second trimester medical abortion resulted in a higher success rate than sublingual misoprostol at 24 hours but the abortion rate was similar at 48 hours. Vaginal misoprostol should be the regimen of choice but sublingual misoprostol is also an effective alternative.