Medical abortion in late second trimester--a comparative study with misoprostol through vaginal versus oral followed by vaginal route.

ABSTRACT

A randomised controlled trial was conducted to compare the relative efficacies of two regimens Misoprostol given only vaginally or orally followed by vaginal administration of the same drug, for second trimester abortion. Multiparous women with a pregnancy of 16 to 20 weeks with no contra-indications to the drug were selected. They were randomly allocated into two groups. Patients in the first group, the 'only vaginal misoprostol' group (n = 30), were given misoprostol 400 microg 6 hourly only through vaginal route up to a maximum of 4 such doses. Women in the other group, the 'oral plus vaginal misoprostol' group (n = 24), received 400 microg of the drug at intervals of 12 hours for 2 doses, followed by 400 microg 6 hourly per vaginum up to a maximum of 4 such. Ten units of oxytocin was started in all cases when os was 4 cm dilated. Complete expulsion was 83.33% with an average time of 13.28 hours in the only vaginal misoprostol group. Complete expulsion occurred in 87.5% of women receiving oral followed by vaginal misoprostol with an average time of 8.93 +/- 0.01 hours from the first vaginal dose (p<0.05). More importantly, 66.67% women in second group delivered within 10 hours of the vaginal dose. Complete expulsion was defined in those cases where no check curettage was needed. Side-effects were not significant. This implies that misoprostol given by the vaginal route following oral priming doses had a higher success rate and a potential for a reduced hospital stay and higher bed turn-over rate.