Termination of pregnancy; comparison of sublingual and vaginal misoprostol in second trimester

ABSTRACT

To compare the efficacy of vaginal misoprostal with that of sublingual misoprostol in 2nd trimester of pregnancy by comparing the induction-expulsion interval between two groups of patients induced with vaginal and sublingual misoprostol. Interventional, quasi experimental study. Obstetrics and Gynaecology Unit 1, Sir Ganga Ram Hospital, Lahore. Thirteen months form October 2006 to November 2007. Sixty women at 12-26 weeks of gestation which were selected for termination of pregnancy were assigned into two groups. Thirty women received sublingual misoprostol and thirty women received vaginal misoprostol. Dosage regimen was tablet Misoprostol 200 micro g 4 hours apart till expulsion of fetus [maximum 5 doses]. Main outcome measures were 1. Induction-expulsion intervals 2. Maternal side effects 3. Fever 4. Nausea/vomiting 5. Diarrhea. Mean induction-expulsion interval in vaginal group was 11.8 +/- 8.3 hours and in the sublingual group was 12.8 +/- 8.5 hours. Percentage of complete expulsion was 53.3% in both groups. Cases of failed induction in vaginal group were 10% and in sublingual group were 13.3%. One case [3.3%] of fever and two cases [6.6%] of vomiting were observed in sublingual group and one case [3.3%] of vomiting was observed in vaginal group. Both routes appear to be equally efficacious for mid trimester pregnancy termination, without significant side effects