Comparison of Sublingual and Vaginal Misoprostol for Second-Trimester Pregnancy Terminations
Abstract
Objective: Comparing sublingual and vaginal misoprostol in second trimester pregnancy termination.
Materials and methods: In this study 268 women at 12-24 weeks of gestation candidate for pregnancy termination were enrolled. Women were randomly divided in two groups. The first group received 400 µg sublingual misoprostol and vaginal placebo and the second group received 400 µg vaginal misoprostol and sublingual placebo every 4 hours for a maximum of five doses. The course of misoprostol was repeated if the women did not abort within 24 hours.
}Results: The median induction-to-abortion interval was shorter in sublingual group (12/72 hours in sublingual and 14/67 hours in vaginal). There was no significant difference in the success rate at 24 and 48 hours and in side effects. The preference for the sublingual route of administration was higher.Both vaginal and sublingual misoprostol are effective for medical abortion in second trimester termination.
Conclusion: But it appears from shorter induction interval in sublingual and higher acceptability that sublingual route is a better choice.
Cabrera Y, Fernández-Guisasola J, Lobo P, Gámir S, Alvarez J. Comparison of sublingual versus vaginal misoprostol for second-trimester pregnancy termination: A meta-analysis. Aust N Z J ObstetGynaecol 2011;51:158-65
Wildschut H, Both MI, Medema S, Thomee E, Wildhagen MF, KappN. Medical methods for midtrimester termination of pregnancy. Cochrane Database Syst Rev 2011; 19: D005216.
Ho PC, Blumenthal PD, Gemzell-Danielsson K, Gómez Ponce de León R, Mittal S, Tang OS. Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks.Int J GynaecolObstet 2007; 99Suppl 2:S178-81.
Tanha FD, Golgachi T, Niroomand N, Ghajarzadeh M, Nasr R. Sublingual versus vaginal misoprostol for second trimester termination: a randomized clinical trial. Arch GynecolObstet2013;287:65-9.
Tang OS, Lau WN, Chan CC, Ho PC. A prospectiverandomised comparison of sublingual and vaginal misoprostol in second trimester termination of pregnancy. BJOG 2004;111:1001-5.
Bartusevicius A, Barcaite E, Nadisauskiene R.Oral,Vaginal and sublingual misoprostol for induction of labor. Int J Gynaecol Obstet 2005;91:2-9.
Tang OS, Xu J, Cheng L, Lee SW, Ho PC. Pilot study on the use of sublingual misoprostol with mifepristone in termination of first trimester pregnancy up to 9 weeks gestation.Hum Reprod 2002;17:1738-40.
Tang OS, Ho PC. Pilot study on the use of sublingualmisoprostol for medical abortion. Contraception. 2001; 64:315-7.
Bhattacharjee N, Saha SP, Ghoshroy SC, Bhowmik S, BaruiG.Arandomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy. Aust N Z J ObstetGynaecol 2008; 48:165-71.
Saxena P, Salhan S, Sarda N. Comparison between the sublingual and oral route of misoprostol for preabortion cervical priming in first trimester abortions. Hum Reprod 2004; 19:77-80.
Tang OS, Gemzell-Danielsson K, Ho PC. Misoprostol: pharmacokinetic profiles, effects on the uterus and sideeffects. Int J GynaecolObstet 2007; 99(Suppl 2): S160–7.
Von HertzenH, PiaggioG, WojdylaD, Nguyen TM, MarionsL, OkoevG, et al. Comparison of vaginal and sublingual misoprostol for second trimester abortion: randomized controlled equivalence trial. Hum Reprod2009;24:106-12.
Tang OS, Lau WN, Chan CC, Ho PC. A prospectiverandomised comparison of sublingual and vaginal misoprostol in second trimester termination of pregnancy. BJOG 2004; 111:1001-5.
Saxena P, Salhan S, Sarda N.Role of sublingual misoprostol for cervical ripening prior to vacuum aspiration in first trimester interruption of pregnancy. Contraception 2003;67:213-7.
Singh K, Fong YF, Prasad RN, DongF. Does an acidic medium enhance the efficacy of vaginalmisoprostolfor pre-abortion cervical priming? Hum Reprod 1999; 14:1635-7.
| Files | ||
| Issue | Vol 8, No 1 (March 2014) | |
| Section | Original Articles | |
| Keywords | ||
| Misoprostol Second Trimester Termination Sublingual Vaginal | ||
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