A comparison of the efficacy of sublingual and oral misoprostol 400 microgram in the management of early pregnancy failure: a randomized controlled trial.

OBJECTIVE: To compare repeated doses of sublingual with oral misoprostol in the medical management of early pregnancy failure. MATERIAL AND METHOD: One hundred and thirty eight women with a period of gestation less than 20 week calculated by her last menstrual period and less than 12 weeks by size were sequentially allocated to two groups to receive either 400 microg of misoprostol orally or sublingually every 4 hours until termination of pregnancy was completed. RESULTS: There is no difference in the mean induction to abortion interval. Fever and chill were more common in sublingual group compared with oral group. The other adverse effects were similar and included nausea, vomiting, diarrhea, abdominal pain, and headache. CONCLUSION: Sublingual misoprostol is as effective as oral route. Most adverse effects are similar in both groups except fever was more common in sublingual group.

Ion channels: new targets for the next generation of tocolytics agents.

Ion channels are interesting molecules since they mediate not only uterine contraction but also uterine relaxation. We have examined the expression, function, and correlation between the large conductance calcium-activated potassium (BKCa) channel, beta2 adrenoceptor (AR), and long-lasting (L) type calcium (Ca2+) channel. These are the main channels and receptor that are involved in the uterine contraction/ relaxation process. Our evidence has shown that BKCa channel is closely correlated with beta2 AR in mediating uterine relaxation. Both proteins are situated in close proximity on the plasma membrane of human myometrium and are downregulated approximately 50% after the onset of labor. Interestingly, L type Ca2+ channel, which involves in the contraction pathway, seems to be in the same compartmentation as BKCa channel/ beta2 AR macromolecular complex. Further studies are now being conducted to identify the signaling complex components that could potentially be a target for new tocolytic agents.