Oral versus Vaginal Misoprostol for Termination of Second Trimester Missed Abortion
Keywords:Misoprostol, missed abortion, uterine hyper stimulation
Background and Objectives: Misoprostol is a synthetic analogue of prostaglandin E1. It became an important drug in obstetric practice because of its uterotonic and cervical ripening effects. This study was done to compare the effectiveness of it in oral versus vaginal route for termination of second trimester missed abortion.
Methods: From 1st of October 2008 to the end of June 2009 at maternity teaching hospital in Erbil, a clinical comparative study was done on 90 patients who had second trimester missed abortion, They were randomly assigned to receive either oral misoprostol tablets(45 patients) in dose of 200 microgram every 4 hours or vaginal misoprostol tablets (45 patients) in dose of 200 microgram every 4 hours. The patients were followed for 48 hours.
Results: The mean induction to abortion interval was significantly shorter for vaginal group (9.98�4.56hours versus 13.30�6.24hours, P=0.005). More patients in vaginal group aborted within 24 hours (95.6% versus 82.22%, P-value=0.045) .The vaginal group required less number of doses than the oral group (2.09�0.90 versus 2.84�1.24, P=0.001). Gastrointestinal side effects of misoprostol were significantly more in the oral group. Conclusions: Misoprostol was effective drug for termination of second trimester abortion. Vaginal misoprostol resulted in shorter induction to abortion interval, less doses required and fewer side effects than oral misoprostol.
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