Pregnancy and obstetrics. Randomized comparison of vaginal (200 g every 3 h) and oral (400 g every 3 h) misoprostol when combined with mifepristone in termination of second trimester pregnancy

Author： Ngai Suk Wai Tang Oi Shan

Publisher： Oxford University Press

ISSN： 1460-2350

Source： Human Reproduction, Vol.15, Iss.10, 2000-10, pp. : 2205-2208

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Abstract

It is known that when misoprostol is given at 200 g every 3 h after mifepristone pretreatment, the vaginal route is more effective than the oral route. However, women prefer the oral route. This randomized study was to test our hypothesis that oral misoprostol 400 g is as effective as vaginal misoprostol 200 g when given every 3 h in termination of second trimester pregnancy after priming with mifepristone. A total of 142 patients was randomly assigned to group 1 (200 mg mifepristone + 400 g oral misoprostol every 3 h up to five doses) or group 2 (200 mg mifepristone + 200 g vaginal misoprostol every 3 h up to five doses). The incidence of side-effects and the preference study were assessed through a standardized questionnaire during and after the abortion. For the oral group, both the incidence of diarrhoea (40.0 versus 23.2%, P = 0.03) and the amount of drug used (1734 compared with 812 g, P < 0.0001)="" were="" significantly="" higher="" than="" that="" of="" the="" vaginal="" group="" but="" the="" incidence="" of="" fever="" appeared="" to="" be="" lower="" (not="" significant).="" there="" was="" no="" significant="" difference="" in="" complete="" abortion="" rate:="" 81.4%="" in="" the="" oral="" group="" and="" 75.4%="" in="" the="" vaginal="" group.="" the="" median="" induction–abortion="" interval="" was="" similar="" in="" the="" two="" groups="" (10.4="" versus="" 10.0="" h).="" the="" percentage="" of="" women="" who="" aborted="" in="" 24="" h="" was="" also="" similar:="" 57/70="" (81.4%)="" in="" the="" oral="" group="" and="" 58/69="" (87.0%)="" in="" the="" vaginal="" group.="" overall,="" 82.0%="" of="" women="" preferred="" the="" oral="" route.="" oral="" misoprostol="" (400="" g)="" given="" every="" 3="" h="" up="" to="" five="" doses,="" when="" combined="" with="" mifepristone,="" was="" as="" effective="" as="" the="" vaginal="" (200="" g)="" route="" in="" second="" trimester="" termination="" of="" pregnancy.="" this="" regimen="" could="" also="" be="" offered="" to="" those="" women="" who="" found="" repeated="" vaginal="" administration="" unacceptable.="">