Publication:

Comparative study of oral and vaginal misoprostol for cervical priming prior to first trimester suction evacuation

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.