Misoprostol for the purpose of mid-trimester termination of pregnancy: a comparative study with prostaglandin f(2) alpha

ABSTRACT

To compare the efficacy of misoprostol verses prostaglandin F[2]alpha [PGF[2]alpha] in the medical management of termination of mid-trimester pregnancy due to medical reasons. This experimental study was conducted in Obstetrics and Gynaecology Department, Bahawal Victoria Hospital, Bahawalpur for a period of 6 months from April 2005 to September 2005. Time interval between induction with misoprostol or PGF[2]alpha and expulsion of foetus, number of tablets of misoprostol used and total dose of injection PGF[2]alpha used for termination of pregnancy as well as the complications experienced with both drugs. Fifty patients of 18-35 years of age were randomly selected who presented to Gynaecology and Obstetrics outdoor with mid-trimester foetal loss or congenitally malformed foetus incompatible to life, confirmed on ultrasonography. These women were randomised to receive either intravaginal misoprostol or extra-amniotic PGF[2]alpha. Ninety-six percent of cases were managed successfully with Misoprostol as compared to 92% where PGF[2]alpha was tried [p>0.5]. Mean induction to expulsion duration for misoprostol and PGF2alpha were 9.02 +/- 4.57 and 16.04 +/- 6.22 hours respectively [p<0.5]. Complications profile was low especially in cases of PGF[2]alpha and only one case experienced significant haemorrhage. Misoprostol and PGF[2]alpha were found to be of same success rate but former was found to be more efficacious in terms of induction to expulsion duration