A comparison of buccal versus vaginal misoprostol administration for induction of first and second trimester abortion


  • Amita Yadav Department of Obstetrics and Gynaecology, Rani Durgavati Medical College, Banda, Uttar Pradesh, India
  • Nikita Kaushal Department of Obstetrics and Gynaecology, MLN Medical College, Prayagraj, Uttar Pradesh, India
  • Shubhangi Sonkar Department of Obstetrics and Gynaecology, MLN Medical College, Prayagraj, Uttar Pradesh, India




Misoprostol, Abortion, First trimester, Second trimester


Background: Aim of study was to compare effectiveness, adverse effects and patient’s acceptability of buccal and vaginal routes of administration of misoprostol in 1st and 2nd trimester abortion, type of study-randomized control trial

Methods: A total of 200 women with indications for abortion up to 20 weeks of pregnancy were enrolled over a period of 1 year and received misoprostol either through buccal (Group A) or vaginal (Group B) route. Each group containing 50 patients of first trimester and second trimester.

Results: Incomplete abortion rate (25%) was significantly higher in vaginal group while drug related side-effects (47%), patients’ satisfaction and acceptability (82%) was higher in buccal group respectively.

Conclusions: Buccal route may be preferred owing to a better complete abortion rate, better patient satisfaction and acceptability as compared to vaginal route.


Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics, 24th ed. New York: McGraw-Hill. 2015;316-47.

Khan MK, Ali K. Medical termination of pregnancy (Amendment) ACT 2021- A review. IP Int J Forensic Med Toxicol Sci. 2022;7(1):1-3.

Bearak J, Popinchalk A, Ganatra B, Moller A-B, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health. 2020;8(9):e1152-61.

Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health. 2018;6:e111-20.

Visaria L, Ramachandran V, Ganatra B, Kalyanwala S. Abortion in India: emerging issues from the qualitative studies, Economic and Political Weekly. 2004;39(46-47):5044-52.

Elul B, Barge S, Verma S, Kumar N, Bracken H. Unwanted Pregnancy and Induced Abortion: Data from Men and Women in Rajasthan, India, New Delhi: Population Council. 2004.

World Health Organization. Medical management of abortion. Geneva: World Health Organization. 2018. Available at: https://apps.who.int/iris/bitstream/ handle/10665/278968/9789241550406-eng.pdf. Accessed on 3 June 2022.

Turner JV, Agatonovic-Kustrn S, Ward H. Off-label use of misoprostol in gynaecology. Facts Views Vis Obgyn. 2015;7(4):261-4.

Speer L. Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion. Am Fam Physician. 2019;100(2):119.

Hobday K, Hulme J, Homer C, Zualo Wate P, Belton S, Prata N. My job is to get pregnant women to the hospital": a qualitative study of the role of traditional birth attendants in the distribution of misoprostol to prevent post-partum haemorrhage in two provinces in Mozambique. Reprod Health. 2018;15(1):174.

Bhandekar SS, Chauhan AR, Ambadkar A. Prospective Comparative Study of Oral Versus Vaginal Misoprostol for Second-Trimester Termination of Pregnancy. J Obstet Gynaecol India. 2018;68(6):456-61.

Mukherjee AA. Comparison of Effectiveness of Sublingual and Vaginal Misoprostol for Second-Trimester Abortion. J Obstet Gynaecol India. 2019;69(3):246-51.

Khan N, Kant AM, Thukra PC, Saquib M. Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion. Int J Reprod Contracept Obstet Gynecol. 2019;8:3368-3.

Al RA, Yapca OE. Vaginal Misoprostol Compared With Buccal Misoprostol for Termination of Second-Trimester Pregnancy: A Randomized Controlled Trial. Obstet Gynecol. 2015;126(3):593-8.

Young D, Fitzgerald K, Laursen L, Whitaker AK. Comparison of vaginal and buccal misoprostol after mifepristone for medication abortion through 70 days of gestation: A retrospective chart review. Contraception. 2022;S0010-7824(22)00168-8.

Garg G, Takkar N, Sehgal A. Buccal versus vaginal misoprostol administration for the induction of first and second trimester abortions. J Obstet Gynaecol India. 2015;65(2):111-6.






Original Research Articles