Effectiveness of Vaginal Versus Buccal Misoprostol for First Trimester Induced Abortions- A Comparative Study

Abstract

BACKGROUNDAbortion can be induced by medical or surgical methods, of which medical abortion is safer, including misoprostol, administered by various routes. Vaginal administration, although effective, may require repeated vaginal examinations, being inconvenient and unacceptable at times. This has paved way for other routes of misoprostol administration such as buccal and sublingual, with additional benefits including ease of administration and lesser infection rate. Objectives-To compare the safety, effectiveness and patient satisfaction of vaginal and buccal misoprostol in first trimester induced abortion. MATERIALS AND METHODSA prospective randomised study in hundred women undergoing first trimester induced abortion up to 49 days were divided into two groups. Group A, with 50 patients, were given oral mifepristone (200 mg) followed by vaginal misoprostol (800 mcg). Group B, with 50 patients, were given oral mifepristone (200 mg) followed by buccal misoprostol (800 mcg). Results were compared in both the groups in term of safety, effectiveness and patient satisfaction. RESULTSIn both the groups, first trimester induced abortions up to 49 days (7 weeks) were safe. The efficacy as judged by complete abortion was 88% in group A (vaginal) and was 94% in group B (buccal). No statistical significant difference in safety and complete abortion was observed. Statistical significant adverse effects noticed was altered taste in group B (buccal). No statistical significant difference in patient satisfaction in both groups was observed. CONCLUSIONVaginal and buccal misoprostol have similar efficacy and patient satisfaction. For first trimester induced abortion, buccal route can be used as an effective alternative.

Outcome of First Trimester Induced Abortions Using Misoprostol by Buccal and Vaginal Routes

“…8 In our study, no statistically significant differences were noted among side effects, except for altered taste in a buccal group. The findings were consistent with studies conducted by Khan et al 6 and Nath and Kumar. 8 The rate of complete abortion was 92.7% in the vaginal group and 91% in a buccal group (p-value = 0.72) showing both routes were equally effective.…”

“…8 The rate of complete abortion was 92.7% in the vaginal group and 91% in a buccal group (p-value = 0.72) showing both routes were equally effective. Similar results were noted in studies conducted by Khan et al, 6 Raj and Pradhan 7 and Nath and Kumar. 8 In our study, the satisfaction rate was 89% in the vaginal group and 92% in a buccal group.…”

“…In our study, the mean age of study subjects was 27.51 years in the vaginal group and 27.04 years in the buccal group, which is comparable to other studies. 6,7 In our study, maximum study subjects were multiparas, which is comparable to other studies. 6 In our study, there was no statistically significant difference among the gestational age of study subjects in both the buccal and vaginal groups.…”

“…6,7 In our study, maximum study subjects were multiparas, which is comparable to other studies. 6 In our study, there was no statistically significant difference among the gestational age of study subjects in both the buccal and vaginal groups. This is comparable to other studies.…”