Publication:

A comparative study of oral, sublingual and vaginal route of misoprostol as cervical ripening agent before surgical method of termination of first-trimester pregnancy

Background Cervical ripening is a critical step for surgical method of termination of first trimester of pregnancy. Misoprostol, PGE1 analogue have promising role as cervical ripening agent. The present study aimed to compare the efficacy and side effects of oral, sublingual and vaginal misoprostol at dosage of 400mcg for cervical priming before surgical method of termination in first-trimester pregnancy.

Methods It was a prospective hospital based randamosied study. Total 150 patients at 6-12 weeks gestation requesting for medical termination of pregnancy were divided equally in to 3 groups. Every group was advised to have single dose of 400 mcg misoprostol either oral, sublingual or vaginal route respectively 4 hour before suction and evacuation.

Results The sublingual group had highly significant cervical dilatation (P<0.001) and the duration of suction and evacuation was less as compared to the vaginal and oral routes (p<0.000). However, the mean intraoperative blood loss was more in sublingual as compared to the vaginal and oral groups. Loose motions and nausea/vomiting were more with oral routes while blood loss was more in the vaginal route.

Conclusions Thus, it can be concluded from present study that sublingual route of misoprostol is more preferable than oral or vaginal route as pro-abortion cervical ripening agent.