DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172924

Tablet misoprostol as a cervical priming agent prior to surgical abortion

Vijaya Manohar Revankar, Harsha T. N.

Abstract


Background: Every effort to promote effective contraceptive methods as well as emergency contraception is being made, still there would be a need and place for termination of pregnancy. Objective of present study was to evaluate and to know the efficacy and adverse effects of tablet misoprostol 400 micro gram as a cervical priming agent administered either by oral or vaginal route, 3 hours before MTP.

Methods: Prospective randomized not blinded study carried out for two years at Government Tertiary care level hospital, OBG Department, Mangalore on 100 women with gestational age up to 12 weeks requesting for surgical abortion.

Results: In both the groups there was no significant statistical difference with respect to age (p=0.44), parity and gestational age (p=0.59). With respect to baseline cervical dilatation significant statistical difference was not observed in both the groups. Baseline dilatation of the cervix was 8.0 mm versus 8.2 mm (p value=0.55). Baseline cervical dilatation was ≥7mm in 90% of women when tab misoprostol was given by oral route and 94% with vaginal route. There was no significant statistical difference with respect to side effects (p value>0.05) except nausea (p=0.01) found in both the groups. Gastro Intestinal side effects were more in oral misoprostol group, but it was not statistically significant.

Conclusions: Oral route is an effective alternative to vaginal route. Oral route is preferred over vaginal route because women can do self-administration at home and there was no internal examination discomfort.


Keywords


Cervical dilatation, Cervical priming, Misoprostol, Surgical abortion

Full Text:

PDF

References


Grimes DA, Schulz KF, Cates Jr WJ. Prevention of uterine perforation during curettage abortion. JAMA 198;2511(16):2108-11.

Schulz KF, Grimes DA, Cates Jr W. Measures to prevent cervical injury during suction curettage abortion. Lancet. 1983;1(8335):1182-5.

Royal College of Obstetrics and Gynecologist. Clinical effectiveness support unit. the care of women requesting induced abortion. London: RCOG Press; 2000.

Ashok PW, Flett GM, Temploton A. Mifepristone versus vaginally administered misoprostol for cervical ripening before first trimester termination of pregnancy: a randomized controlled study. Am J Obstet Gynecol. 2000;183(4);998-1002.

Zieman M Fong SK, Benowitz NL, Banskter and Carney P D. Absorption Kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997;90:88-92.

Fong YF, Singh K, Prasad RN. A comparative study using Two dose regimens of vaginal misoprostol for preabortive cervical dilatation in the first trimester nulliparae. Br J Obstet Gynecol. 1998;105(4):413-7.

Lawrie A, Penny G, Templeton A. A randomized comparison of oral and vaginal misoprostol for cervical priming before suction termination of pregnancy. Br J Obstet Gynecol. 1996;103(11):1117-9.

Oppegaard K, Quigstad E, Nesheim B. Oral versus self-administered vaginal misoprostol at home before surgical termination of pregnancy a randomized controlled trial. Br J Obstet Gynecol. 2006;113:58-64.

Mac Isaac L, Grossman D, Balistreri E, Carney P. A randomized controlled trial of Laminaria, oral misoprostol and vaginal misoprostol before abortion. Obstet Gynecol. 1999;93:766-70.

Ashok PW, Hamoda H, Nathani F, Flett GM, Templeton A. Randomized controlled study comparing oral and vaginal misoprostol for cervical priming prior to surgical termination of pregnancy. Br J Obstet Gynecol. 2003;110:1057-61.

Ngia SW, Chan YM, Tang OS, Lao T, Ho PC. The use of misoprostol for preoperative cervical dilatation prior to vacuum aspiration: a randomized trial. Him Repord. 1999;14(8):2139-42.

Carbonel JL, Velazco A, Rodriguez Y. Oral versus vaginal misoprostol for cervical priming in first trimester abortion: A randomized trial. Eur J Contracept Report Health Care. 2001;6(3):134-140.