Comparison of Effectiveness of Sublingual and Vaginal Misoprostol for Second-Trimester Abortion.

Abstract

The aim of this study was to compare the efficacy and safety of sublingual and vaginal misoprostol in second-trimester termination of pregnancy in 24 and 48h. This is a retrospective study of 240 pregnant women seeking termination in second trimester (13-18.5weeks), in which the patients are subdivided into two groups-first group received 400mcg of misoprostol sublingually (n = 120), and second group received 400mcg of misoprostol vaginally (n = 120) every 4h for a maximum of five doses. The course of misoprostol was repeated if the patient did not abort within 24h. The mean induction-to-abortion interval was shorter in sublingual group (10.28 ± 3.1h) versus 14.68 ± 4.2h in vaginal group in 24h (p = 0.0001), and 36.9 ± 4.4h in sublingual versus 29.7 ± 14 in vaginal group in 48h (p = 0.0933). Mean dose requirement for misoprostol by sublingual route was low as compared to vaginal misoprostol (1048 ± 301mg versus 1250 ± 375mg; p = 0.0001 in 24h and 1110 ± 833mg versus 1325 ± 536mg; p = 0.0231 in 48h). No significant difference was found in the success rate (both at 24 and 48h) and in side effects among the two comparison groups. Misoprostol as such by any route has been proven as an effective abortifacient in second trimester. Both sublingual and vaginal routes are effective for medical abortion. But shorter induction-to-abortion interval in sublingual route, less dose requirement and higher acceptability makes sublingual route as a better choice.