Comparative analysis of vaginal misoprostol 400 and 600 single dose for second-trimester termination of pregnancy-a prospective randomized trial
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232729Keywords:
Misoprostol, Multiple dose, Post-expulsion, Second-trimester, Single doseAbstract
Background: This study was done to compare two dosing schedules of tablet misoprostol single dose 600 µg (M600) versus multiple doses 400 µg (M400), kept per vaginally for second termination of pregnancy and to analyze induction to abortion time, side effects, and failure to achieve termination of pregnancy.
Methods: Women admitted for second-trimester pregnancy termination were considered. Inclusion and exclusion criteria were followed. The women were randomized into two groups, with one group receiving single dose of M600 per vaginal and the other one multiple doses of M400, and the two groups were compared in their outcomes.
Results: In the present study no statistical significance was found between the two dosing regimens with regard to induction abortion interval, post-expulsion need for suction, and evacuation.
Conclusions: The study revealed that the dose between M400 and M600 has not shown significance compared with two dosing regimens. Single dose M600 can be considered for second-trimester pregnancy termination due to better compliance.
References
WHO. Fact sheet- Abortion. Available from: https://www.who.int/news-room/fact-sheets/detail/abortion. Accessed on 1 February 2023.
Jones RK, Kooistra K. Abortion incidence and access to services in the United States, 2008. Perspect Sex Reprod Health. 2011;43:41-50.
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(1);e111-20.
Mohd KK, Kashif A. Medical termination of pregnancy (Amendment) ACT 2021- a review. Int J Forens Med Tox Sci. 2022;7:1-3.
Dalvie SS. Second trimester abortions in India. Reprod Health Matters. 2008;16(31):35-7.
Carbonell JL, Torres MA, Reyes R, Ortega L, Garcia-Gallego F, Sanchez C. Second-trimester pregnancy termination with 600-μg versus 400-μg vaginal misoprostol and systematic curettage postexpulsion: a randomized trial. Contraception. 2008;77(1):50-5.
Dickinson JE. The optimization of intravaginal misoprostol dosing schedules in second-trimester pregnancy termination. Am J Obstet Gynecol. 2022;470-4.
Bhattacharyya SK, Mukherji J, Kamilya SG, Ray S, Hazra A. Two regimens of vaginal misoprostol in second trimester termination of pregnancy a prospective randomised trial. Acta Obstet Gynecol. 2006;85:1458-62.
Ruangchainikhom W, Phongphissanou E, Bhekasuta J, Sarapak S. Effectiveness of 400 or 600 micrograms of vaginal misoprostol for terminations of early pregnancies. J Med Assoc Thai. 2006;89(7):928-33.
Herabutya Y, Chanrachakul B, Punyavachira P. Second trimester pregnancy termination: a comparison of 600 and 800 micrograms of intravaginal misoprostol. J Obstet Gynaecol Res. 2001;27:125-8.
Tang OS, Ting Lau WN, Wai Chan CC, Ho PC. A prospective randomized comparison of sublingual and vaginal misoprostol in second trimester termination of pregnancy. Br J Obstet Gynecol. 2004;111:1001-5.
Dickinson JE, Godfrey M, Evans SF. Efficacy of intravaginal misoprostol in second-trimester pregnancy termination: a randomized controlled trial. J Matern Fet Med. 1998;7:115-9.
