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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 122-127    DOI: 10.31083/j.ceog.2021.01.2143
Original Research Previous articles | Next articles
Intravaginal misoprostol versus sublingual misoprostol for second trimester pregnancy termination: a randomized controlled trial
Saipin Pongsatha1, *(), Theera Tongsong1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Abstract  
Objective: To compare the efficacy and adverse effects of 400 mcg misoprostol for second trimester pregnancy termination via the intravaginal or sublingual route. Methods: In this study, 170 women at GA 14-28 weeks underwent termination of pregnancy. They were randomized to receive either intravaginal or sublingual 400 mcg misoprostol at 6 hour intervals until fetal expulsion occurred or within 48 hours after the initiation of the first dose of misoprostol. The primary outcomes were median abortion time and percentage of failure. The secondary outcomes included rates of maternal adverse effects, oxytocin use and analgesia requirement. Results: Intravaginal misoprostol demonstrates significantly greater efficacy for pregnancy termination compared to sublingual misoprostol at the same dosage. The median time to abortion was 16.66 hours or 22.88 hours in the intravaginal group and sublingual group respectively. Maternal adverse effects, specifically rate of chill and diarrhea, were statistically higher in the sublingual group. Conclusion: Intravaginal misoprostol was superior to sublingual misoprostol in terms of shorter abortion time and fewer adverse effects. In addition the rate of oxytocin use was found to be higher in the sublingual group. In conclusion misoprostol via the intravaginal route for should be considered for second trimester pregnancy termination rather than the sublingual route due to greater efficacy and fewer adverse maternal effects.
Key words:  Intravaginal      Sublingual      Second trimester      Pregnancy termination     
Submitted:  14 May 2020      Revised:  09 August 2020      Accepted:  15 August 2020      Published:  15 February 2021     
Fund: CMU-2563/Chiang Mai University Research Fund
*Corresponding Author(s):  Saipin Pongsatha     E-mail:  saipin.pongsatha@cmu.ac.th

Cite this article: 

Saipin Pongsatha, Theera Tongsong. Intravaginal misoprostol versus sublingual misoprostol for second trimester pregnancy termination: a randomized controlled trial. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 122-127.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2143     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/122

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