Randomized comparison of vaginal and sublingual misoprostol with mifepristone priming in termination of second trimester pregnancy

Authors

  • Shrikrushna Vasant Chavan Department of Obstetrics and Gynecology, Topiwala National medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
  • Niraj Nilkanth Mahajan Department of Obstetrics and Gynecology, Topiwala National medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
  • Arundhati Gundu Tilve Department of Obstetrics and Gynecology, Topiwala National medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20194323

Keywords:

Mifepristone, Misoprostol, Second Trimester, Sublingual, Vaginal

Abstract

Background: Sublingual Misoprostol 200 ug 4 hrly is as effective or less effective than vaginal Misoprostol 200ug 4hrly with 200mg oral Mifepristone in termination of second trimester pregnancy.

To compare effectiveness, side-effects, and patient satisfaction of sublingual vs vaginal misoprostol administration.

Methods: It was prospective randomized open label study. 60 women 13-20 weeks of gestation with a valid legal indication for termination of pregnancy as per MTP act in INDIA were enrolled for study, randomly divided into Group A- Sublingual (n=30) group B-Vaginal (n=30). For group A, 200 mg of Mifepristone was given, 48h later Misoprostol 200 µg was given sublingually 4hrly up to a maximum of 5 doses. If abortion does not occur, the pregnancy was terminated with vaginal misoprostol, in group A. Same procedure repeated in group B. If abortion fails to occur after 5 doses, then second course of vaginal misoprostol was given in group B. Failure of procedure was defined as failed expulsion of foetus at 48 hrs.

 Results: Mean induction-abortion interval in vaginal group was 12.8±4.38h and 11.47±4.42h in sublingual group was comparable with insignificant p value (p=0.136). All the side effects were comparable in both groups. The overall success rate was 93.3% in the sublingual group while it was 100% in the vaginal group.

Conclusion: Vaginal misoprostol with oral mifepristone priming in second -trimester medical abortion has a shorter time to pregnancy termination compared with a sublingual regimen. However, both the routes are equally effective for induction of abortion.

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Published

2019-09-25

How to Cite

Chavan, S. V., Mahajan, N. N., & Tilve, A. G. (2019). Randomized comparison of vaginal and sublingual misoprostol with mifepristone priming in termination of second trimester pregnancy. International Journal of Research in Medical Sciences, 7(10), 3869–3873. https://doi.org/10.18203/2320-6012.ijrms20194323

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Original Research Articles