Sublingual v/s vaginal misoprostol for second trimester termination of pregnancy: A comparative study

Abstract

Background: Misoprostol is a recommended drug for medical termination of pregnancy in both first and second trimester of pregnancy. Considering the various routes and different doses of administration of the drug available, the aim of the study was to compare the efficacy of misoprostol by sublingual and vaginal route for second trimester MTP. Materials and Methods: This prospective comparative study was conducted on seventy women who were randomly assigned into two groups. Thirty-five women received 400mcg of misoprostol at every 4 hours interval for a maximum of 5 doses by sublingual route and 35 women received the same dose by vaginal route. The efficacy of misoprostol (expulsion of products of conception) and induction-abortion interval were studied in the two groups. Instrumental evacuation was done for incomplete abortion. Oxytocin augmentation was given for cases who failed to abort after the last dose of misoprostol. Results: Majority of women (71%) in both the groups required 3 to 4 doses of misoprostol for abortion. Misoprostol was effective in 74% women in the sublingual group and in 71% women in the vaginal group. The mean induction-abortion interval was 18.69 h and 18.43 h in sublingual and vaginal group respectively. No statistically significant difference was found between the two groups in terms of efficacy of misoprostol in achieving complete abortion. Conclusion: Both sublingual and vaginal routes of administration of misoprostol appear to be safe and equally effective for second trimester MTP.