title: A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages.
abstract: BACKGROUND
  A randomized controlled trial comparing sublingual with vaginal administration of misoprostol for medical management of silent miscarriages.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. ostang@graduate.hku.hk
authors.forename: Oi Shan
authors.initials: OS
authors.lastname: Tang
authors.forename: Winnie Nga Ting
authors.initials: WN
authors.lastname: Lau
authors.forename: Ernest Hung Yu
authors.initials: EH
authors.lastname: Ng
authors.forename: Sharon Wai Heung
authors.initials: SW
authors.lastname: Lee
authors.forename: Pak Chung
authors.initials: PC
authors.lastname: Ho
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000022:Abortion, Spontaneous / Q000188:drug therapy*; D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol