Acta Obstetricia Et Gynecologica Scandinavica 12/2005; 84(11):1125-6. · 1.77 Impact Factor
ABSTRACT: To compare the efficacy, side effects and acceptability of sublingual and vaginal misoprostol for second trimester medical abortion.
Prospective randomised controlled trial.
Tertiary referral unit and a teaching hospital.
Two hundred and twenty-four women at 12 to 20 weeks of gestation.
The women were randomised to receive either sublingual or vaginal misoprostol 400 microg every 3 hours for a maximum of five doses. The course of misoprostol was repeated if the woman did not abort within 24 hours.
The success rate at 48 hours, induction-to-abortion interval and the side effects.
There was no significant difference in the success rate at 48 hours (sublingual: 91%; vaginal: 95%). However, the success rate at 24 hours was significantly higher in the vaginal group (85%) compared with the sublingual group (64%). There was no difference in the median induction-to-abortion interval (sublingual: 13.8 hours; vaginal: 12.0 hours). Significantly more women in the sublingual group preferred the route to which they were assigned when compared with the vaginal group. The incidence of fever was also less in the sublingual group.
The use of vaginal misoprostol for second trimester medical abortion resulted in a higher success rate than sublingual misoprostol at 24 hours but the abortion rate was similar at 48 hours. Vaginal misoprostol should be the regimen of choice but sublingual misoprostol is also an effective alternative.
BJOG An International Journal of Obstetrics & Gynaecology 10/2004; 111(9):1001-5. · 3.41 Impact Factor
ABSTRACT: A randomized controlled trial comparing sublingual with vaginal administration of misoprostol for medical management of silent miscarriages.
Eighty women who had silent miscarriages (<13 weeks) were randomized to receive 600 micro g of misoprostol every 3 h for a maximum of three doses either sublingually or vaginally.
The success rates of medical management were the same in both groups (87.5%; 95% CI: 74-95%). There were no serious complications. The incidence of diarrhoea was higher in the sublingual (70%) than the vaginal route (27.5%) (P < 0.005). Other side effects were similar in each group, although fatigue was experienced by more women in the sublingual group than in the vaginal group (65 versus 40%: P = 0.043). The overall acceptability of medical management was good. Most women would choose the medical method if they were allowed to choose again and would recommend the method to others.
The current regimen of misoprostol is useful for the management of silent miscarriage in terms of complete miscarriage rate and patient acceptability. Sublingual misoprostol may offer an alternative for women who do not like repeated vaginal administration of the drug.
Human Reproduction 01/2003; 18(1):176-81. · 4.47 Impact Factor