Published: 2019-05-28

Comparative study of efficiency of vaginal versus oral misoprostol along with mifepristone for first trimester medical termination of pregnancy

Latika R. Mehta, Grishma P. Agrawal


Background: Authors estimate that 15.6 million abortions (14.1 million-17.3 million) occurred in India in 2015. Incomplete abortion is a known disadvantage of medical method of abortion reported in 0.2-3% of cases. Though Misoprostol can be used with different routes including oral, sublingual and vaginal, few evidences are available in drug effectiveness as well as its related side effects when used through different routes and more so in India. The present study is aimed to compare the efficacy of misoprostal in first trimester abortion when taken vaginally as compared to orally. Thus, whichever route results in lower rates of incomplete abortions, can be employed in our health set up, minimizing the complications of failed first trimester MTP.

Methods: An experimental study was conducted on 74 women seeking termination of pregnancy within 9 weeks of amenorrhea during the period of 9 months in a tertiary care institute. Tablet mifepristone 200 mg was given to all participants. After 48 hours, 37 women were given 800 mcg tablet of Misoprostol for oral consumption while other 37 women were given 800 mcg Misoprostol for self-administering vaginally. Abortion status and complications were checked.

Results: The complete abortion rates in vaginal group and oral group were 97.3% and 86.49 % respectively. Satisfaction was more in case of vaginal misoprostol, while side effects were similar in both groups.

Conclusions: Mifepristone with vaginal misoprostol was more effective as compared to oral misoprostol for first trimester abortion.


Medical abortion, Mifepristone, Misoprostol, Oral, Vaginal

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Bhaskar A, Kaushik R, Kumar A. A prospective comparative study of oral and vaginal misoprostol after pre-treatment with single dose of mifepristone for second trimester abortion. Int J Reprod Contracept Obstet Gynecol. 2017;7(1):272-6.

Government of India, The Medical Termination of Pregnancy Act, No. 34; 1971.

Government of India, Medical Termination of Pregnancy Rules and Regulations, Vide GSR 2543; 1975.

Government of India. The Medical Termination of Pregnancy Act, 1971 (Act No. 34 of 1971), and MTP Rules and Regulations, 2003 (GSR No. 485(E)). New Delhi: Gazette of India; 2003.

World health organization. Unsafe abortion global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000. 4th edition WHO; 2004.

Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. The Lancet Global Health. 2018;6(1):e111-20.

Patel U, Chauhan K, Singhi S, Kanani M. Second trimester abortion-mifepristone and misoprostol or misoprostol alone? Int J Reprod Contracept Obstet Gynecol. 2016;2(3):315-9.

Patel BS. Early pregnancy termination with oral mifepritone and vaginal misoprostal. Paripex-Indian J Res. 2018;6(8).

Shetty J MNV. Medical abortion by mifepristone with oral versus vaginal misoprostol. J Obstet Gynecol India. 2006;56(6):529-31.

El-Rafaey H, Rajasekar D, Abdalla M. Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol. N Engl J Med. 1995;332:983-7.

Sahu RR, Soni AA, Raut VS. Randomized control study of oral versus vaginal and sublingual misoprostol with mifepristone for first-trimester MTP. Indian J Clin Pract. 2013;24(7):668-73.