Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE 5 ( September-October, 2024 ) > List of Articles

RESEARCH ARTICLE

Oral vs Vaginal Misoprostol for Medical Termination of Pregnancy

Priyankur Roy, Aditi Nadkarni, Laxmi Narayan Sahoo, Kalyani Singh, Ruchika Garg

Keywords : Abortion, Medical termination of pregnancy, Misoprostol, Prostaglandin

Citation Information : Roy P, Nadkarni A, Sahoo LN, Singh K, Garg R. Oral vs Vaginal Misoprostol for Medical Termination of Pregnancy. J South Asian Feder Obs Gynae 2024; 16 (5):476-478.

DOI: 10.5005/jp-journals-10006-2200

License: CC BY-NC 4.0

Published Online: 23-10-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Considering the different available results on the effectiveness of various doses of misoprostol and methods of administration. The aim of this study was to compare oral and vaginal misoprostol for medical termination of pregnancy (MTP). Materials and methods: This randomized clinical trial study was performed on 140 pregnant women, who wanted MTP. Pregnant women were divided randomly into two groups – oral and vaginal misoprostol groups by simple sampling. Misoprostol 400 μg was given to both groups every 4 hours up to five times. The effectiveness of misoprostol (the excretion of gestation products) and its side effects (bleeding, fever, etc.) were studied in two groups. The data collection instrument was a questionnaire. Data were analyzed using SPSS (version 22 software). Results: The results showed that there were no statistically significant differences between the oral (82.3%) and vaginal (80%) misoprostol groups in terms of response to treatment. Although in our study, the need for curettage was higher in the vaginal group (42.8) than in the oral group (34.3), the difference was not statistically significant. The intervals between consuming oral misoprostol pills and the excretion of gestation products in the oral and vaginal groups were 4.09 ± 1.56 and 3.67 ± 1.4 hours, respectively. In terms of complications, only two cases of oral misoprostol group experienced complications. Conclusion: Although the risk of complications in the oral method and the need for curettage in vaginal group is high, the effectiveness of oral and vaginal misoprostol for MTP is similar.


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  1. Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetrics, 24th ed., New York: McGraw-Hill; 2015, pp. 316–347. ISBN: 978-0071798938.
  2. Shah I, Ahman E. Unsafe abortion: Global and regional incidence, trends, consequences, and challenges. J Obstet Gynaecol Can 2009;31(12):1149–1158. PMID: 20085681.
  3. G Sedgh ScD. Induced abortion: Incidence and trends worldwide from 1995 to 2008. The Lancet: February 18th, 2012;379(9816):625–632.
  4. Blum J, Winikoff B, Gemzell-Danielsson K, et al. Treatment of incomplete abortion and miscarriage with misoprostol. Int J Gynaecol Obstet 2007;99(Suppl 2):S186–S189. DOI: 10.1016/j.ijgo.2007.09.009.
  5. Muffley PE, Stitely ML, Gherman RB. Early intrauterine pregnancy failure: A randomized trial of medical versus surgical treatment. Am J Obstet Gynecol 2002;187(2):321–325. DOI: 10.1067/mob. 2002.126205.
  6. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility, 7th ed., Lippincott Williams & Willkins; 2005; Chap 28: pp. 1069–1102.
  7. Beucher G, Baume S, Bekkari Y, et al. Medical treatment of early spontaneous miscarriages: A prospective study of outpatient management using misoprostol. J Gynecol Obstet Biol Reprod 2004;33(5):401–406. DOI: 10.1016/s0368-2315(04)96547-7.
  8. Berer M. Medical abortion: A fact sheet. Reprod Health Matters 2005;13(26):20–24. DOI: 10.1016/s0968-8080(05)26212-2.
  9. Burns M, Seattle P. Misoprostol for obstetric and gynecologic uses. Path & Engeder Health 2001;67:438–445.
  10. Gilbert A, Reid R. A randomised trial of oral versus vaginal administration of misoprostol for the purpose of mid-trimester termination of pregnancy. Aust N Z J Obstet Gynaecol 2001;41(4):407–410. DOI: 10.1111/j.1479-828x.2001.tb01318.x.
  11. Saha S, Bal R, Ghosh S, et al. Medical abortion in late second trimester - a comparative study with misoprostol through vaginal versus oral followed by vaginal route. J Indian Med Assoc 2006;104(2):81–82, 84. PMID: 16856588.
  12. Feldman DM, Borgida AF, Rodis JF, et al. A randomized comparison of two regimens of misoprostol for second-trimester pregnancy termination. Am J Obstet Gynecol 2003;189(3):710–713. DOI: 10.1067/s0002-9378(03)00659-8.
  13. Silverstein FE. Improving the gastrointestinal safety of NSAIDs: The development of misoprostol - from hypothesis to clinical practice. Dig Dis Sci 1998;43(3):447–458. DOI: 10.1023/a:1018895417831.
  14. von Hertzen H, Piaggio G, Wojdyla D, et al. Two mifepristone doses and two intervals of misoprostol administration for termination of early pregnancy: A randomised factorial controlled equivalence trial. BJOG 2009;116(3):381–389. DOI: 10.1111/j.1471-0528.2008.02034.x.
  15. Kundodyiwa TW, Alfirevic Z, Weeks AD. Low-dose oral misoprostol for induction of labor: A systematic review. Obstet Gynecol 2009; 113(2 Pt 1):374–383. DOI: 10.1097/AOG.0b013e3181945859.
  16. Behrashi M, Mahdian M. Vaginal versus oral misoprostol for second-trimester pregnancy termination: A randomized trial. Pak J Biol Sci 2008;11(21):2505–2508. DOI: 10.3923/pjbs.2008.2505.2508.
  17. Tale M, Kashanian M, Dehghani Zadeh A. Evaluation of oral misoprostol effect on the treatment of spontaneous first trimester incomplete abortion. RJMS 2004;11(41):441–447. Available from: http://rjms.iums.ac.ir/article-1-32-en.html.
  18. Ayati S, Roudsari FV, Banavi M, et al. Comparison between rectal misoprostol and vaginal misoprostol for first trimester termination of pregnancy in patients with previous uterus surgery. Iran J Obstet Gynecol Infertil 1391;15(42):1–6. DOI: 10.22038/IJOGI.2013.569.
  19. Ganguly RP, Saha SP, Mukhopadhyay S, et al. A comparative study on sublingual versus oral and vaginal administration of misoprostol for late first and early second trimester abortion. J Indian Med Assoc 2010;108(5):283–284, 286. PMID: 21121402.
  20. Dey M. Oral misoprostol is an effective and acceptable alternative to vaginal administration for cervical priming before first trimester pregnancy termination. Med J Armed Forces India 2013;69(1):27–30. DOI: 10.1016/j.mjafi.2012.07.014.
  21. Kaur P, Kaur M, Kaur B, et al. Comparative study of sublingual versus vaginal misoprostol on preoperative cervical priming in first trimester abortion. Ind J Clin Pract 2013;23(9):543–546. Available from: http://imsear.searo.who.int/handle/123456789/182392.
  22. Jahangir M, Behrashi M, Fazel MR, et al. Efficacy of vaginal misoprostol for terminating missed abortion. Feyz 2005;9(2):1–5. Available from: http://feyz.kaums.ac.ir/article-1-136-en.html.
  23. Parveen S, Khateeb ZA, Mufti SM, et al. Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion. Indian J Pharmacol 2011;43(2):172–175. DOI: 10.4103/0253-7613.77356.
  24. Plaut MM, Schwartz ML, Lubarsky SL. Uterine rupture associated with the use of misoprostol in the gravid patient with a previous cesarean section. Am J Obstet Gynecol 1999;180(6 Pt 1):1535–1542. DOI: 10.1016/s0002-9378(99)70049-9.
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