Comparative study of oral and vaginal misoprostol for cervical priming prior to first trimester suction evacuation
Keywords:
Oral misoprostol, Vaginal misoprostol, Cervical primingAbstract
Background: To compare the effectiveness of vaginal with oral misoprostol as a cervical ripening agent prior to first trimester suction evacuation and to compare side effects.
Methods: Hundred and fifty one women opting for medical termination of pregnancy in first trimester were randomized to receive 400µg oral and vaginal misoprostol. Suction evacuation was carried out 3 to 4 hours after misoprostol. Results were analyzed.
Results:Products of conception were noted in 15.8% of patients in vaginal group compared to only 5.3% of patients in the oral group. 89.4% of patients in vaginal group had dilatation of ≥ 7 Hegar’s compared to 58.6% in oral group. Additional dilatation was required in 69.3% in oral group compared to 38.1% patients in vaginal group; all these results being statistically significant. Adverse effects were noted in 50.7% of patients in oral group and 25% of patients in vaginal group.
Conclusion: Comparing the oral and vaginal route of 400µg of misoprostol 3 to 4 hours before suction evacuation, it was observed that vaginal route is associated with better results and fewer side effects.
Metrics
References
Ashok PW, Hamoda H, Nathani F,Flett GMM, Templeton A. Randomized controlled study comparing oral and vaginal misoprostol for cervical priming prior to surgical termination of pregnancy. British Journal of Obstetrics and Gynaecology 2003; 110: 1057 – 1061.
Bugalho A, Bique C, Almeida L, Bergstrom S. Application of vaginal misoprostol before cervical dilatation to facilitate first trimester pregnancy interruption. Obstetrics and Gynecology 1994;83: 729 – 731.
Lawrie A, Penney G, Templeton A. A randomized comparison of oral and vaginal misoprostol for cervical priming before suction termination of pregnancy. British Journal of Obstetrics and Gynaecology 1996; 103: 1117 – 1119.
Oppegaard KS, Qvigstad E, Nesheim BI.Oral versus self-administered vaginal misoprostol at home before surgical termination of pregnancy: a randomized controlled trial. British Journal of Obstetrics and Gynaecology2006; 113: 58-64.
Sharma S, el Refaey H, Stafford M.Oral versus vaginal misoprostol administered one hour before surgical termination of pregnancy: a randomized controlled trial. British Journal of Obstetrics and Gynaecology 2005; 112: 456-460.
Macisaac L, Grossman D, Balistreri E, Darney P. A randomized controlled trial of laminaria, oral misoprostol, and vaginal misoprostol before abortion. Obstetrics and Gynecology 1999;93: 766-770.
Carbonell JL, Velazco A, Rodriguez Y. Oral versus vaginal misoprostol forcervical priming in first-trimester abortion: a randomized trial. European Journal of Contraception and Reproductive Health Care 2001;6(3): 134-140.
