prospective randomized controlled trial of two regimens of vaginal misoprostol in second trimester termination of pregnancy

ABSTRACT

The search continues for a safe effective and cheap method for mid-trimester termination of pregnancy. Misoprostol is a strong contender in this respect. The dose schedule is still not fixed. The objective of this study was to compare the efficacy and adverse effects of two dose regimens of vaginal misoprostol for second trimester termination. Prospective randomized double blind controlled trial was undertaken in 162 women at 14-24 weeks gestation in a teaching hospital. Subjects were randomized to receive either regime A 400 microg of intra vaginal misoprostol every 6h, or regime B 200 microg of intravaginal misoprostol every 6h. The main outcome measure was the success rate at 24h, total dose required, induction-abortion interval and adverse effects. Data was analyzed by student's t-test, Mann-whitney U-test, the chi-squared test or Fisher's exact test. There was a significant difference in the success rate at 24 and 48hr [regime A 74% and 97.5%; regime B 61.7% and 88.9% P=0.016 and 0.029 respectively] and in the mean induction abortion interval [14 Vs 20h, P=0.01] Mean Misoprostol requirement was significantly higher for regime A [731 microg +/- 362 microg vs. 531microg +/- 357 microgm, P=0.001]. Use of 400 microg vaginal misoprostol is superior to 200 microg vaginal misoprostol for second trimester abortion