title: Comparative study of intravaginal misoprostol with gemeprost as an abortifacient in second trimester missed abortion.
abstract: This prospective, randomized study compared the efficacy of intravaginal misoprostol (Cytotec) and gemeprost (Cervagem) as an abortifacient for intrauterine deaths in second trimester pregnancy. Side-effects, complications and the cost-effectiveness associated with each drug were assessed. 21 out of 25 patients (84%) in the misoprostol group aborted whereas only 17 out of 25 patients (68%) in the gemeprost group aborted within 24 hours after the initiation of therapy. In the misoprostol group, the abortion rate was influenced by the gestational age with 100% abortion rate for those > 17 weeks' gestation compared to 67% for those with a gestational age of 13-16 weeks. Side-effects were rare in either group and no major complications were reported in either group. Misoprostol was definitely more cost-effective compared to gemeprost as the mean cost of inducing an abortion using misoprostol was RM 1.08 whereas that of gemeprost was RM 105. We thus concluded that misoprostol was at least as effective as gemeprost as an abortifacient for intrauterine death in second trimester pregnancy. Moreover, it was less costly, with very few side-effects.
authors.affiliation: Hospital Kuala Lumpur, Malaysia.
authors.forename: N S
authors.initials: NS
authors.lastname: Eng
authors.forename: A C
authors.initials: AC
authors.lastname: Guan
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D000030:Abortion, Missed / Q000188:drug therapy* / Q000191:economics; D000282:Administration, Intravaginal; D000527:Alprostadil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; C021182:gemeprost; D000527:Alprostadil