Publication:

Comparative study of sublingual and vaginal misoprostol in second trimester induced abortion

Background To recognize an effective Misoprostol only regime and to compare the efficacy, safety and acceptability of sublingual and vaginal Misoprostol for the termination of second trimester of pregnancy.

Methods The study was a prospective randomized trial. Women attending OPD from January2012 to December 2013, for medical abortion between gestational ages 13-20 weeks were screened, selected and divided in to two groups. Group-A received misoprostol 400 µg then 200 µg sublingually 3 hourly, Group-B received misoprostol 400 µg then 200 µg vaginally 3 hourly. They were observed for 24 hours. Main outcomes were induction-abortion interval, dose required, success rate and side effects and comfort to the route of administration.

Results Mean induction-abortion interval was 9.28 ± 5.824 hours, 95% CI: 7.62-10.94in sublingual misoprostol group and 13.68 ± 6.179 hours, 95% CI: 11.92-15.44 in vaginal group. Mean dose required for abortion was 948 ± 389.264 µg, 95% CI: 837.37-1058.63 in sublingual and 1248 ± 415.142 µg, 95% CI: 1,130.02-1,365.98in vaginal group. Success rate was 98% and 94%, respectively in two groups. The differences were statistically significant. Comfort to the route of administration was 90% in sublingual and 60% in vaginal group.

Conclusions Both sublingual and vaginal routes of Misoprostol are equally effective, safe, inexpensive and acceptable method. Sublingual route is better and preferred by women.