High-dose oral misoprostol for mid-trimester pregnancy interruption.
OBJECTIVE
To evaluate the efficacy of high-dose oral misoprostol for mid-trimester pregnancy interruption.


METHODS
We reviewed our experience with high-dose oral misoprostol for mid-trimester pregnancy interruption from November 1995 to May 1999. Patients undergoing labor induction for intrauterine fetal demise or medically indicated pregnancy termination at 13-32 weeks of gestation with a non-dilated cervix were evaluated. Patients received 400 microg misoprostol orally every 4 h. Women undelivered within 24 h were considered failures and were treated with high-dose oxytocin as previously described. For comparison, a group of women treated with high-dose oxytocin were evaluated.


RESULTS
Forty-seven pregnancies were managed with misoprostol (n = 23) or high-dose oxytocin regimen (n = 24). Both groups were similar with respect to induction indication, gestational age, maternal age/parity, laminaria use, and initial cervical dilation. Induction-to-delivery interval (mean +/- SD) was significantly shorter in the misoprostol cohort (15.2 +/- 6.7 h) compared with those treated with oxytocin (21.7 +/- 11.0 h; p = 0.02). Additionally, a significantly greater percentage of women treated with misoprostol delivered within 24 h (91.0%) compared with the oxytocin group (62.0%; p = 0.04). Adverse outcomes and side effects were not significantly different between the study groups.


CONCLUSIONS
High-dose oral misoprostol is more effective than concentrated oxytocin infusion for mid-trimester pregnancy interruption.
Ramin
Kirk D
KD
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Medical Center, Rochester, MN 55905, USA. ramin.kirk@mayo.edu
Ogburn
Paul L
PL
Danilenko
Diana R
DR
Ramsey
Patrick S
PS
D000019:Abortifacient Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000032:Abortion, Therapeutic; D000284:Administration, Oral; D000328:Adult; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D010121:Oxytocin / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013997:Time Factors; D016896:Treatment Outcome
D000019:Abortifacient Agents; D016595:Misoprostol; D010121:Oxytocin