Oral misoprostol vs. vaginal gemeprost prior to surgical termination of pregnancy in nulliparae.
BACKGROUND
To compare the efficacy and side-effects of intravaginal gemeprost with those of oral misoprostol for cervical ripening prior to first-trimester pregnancy termination in nulliparous women.


METHODS
Retrospective analysis of surgical terminations of pregnancy performed before 90 days of gestation. Intravaginal gemeprost 1 mg or oral misoprostol 800 micro g was administered 2 h before the procedure.


RESULTS
In total, 746 women were enrolled into the study, 84 received intravaginal gemeprost and 662 oral misoprostol. Median baseline cervical dilatation was significantly greater in women who received misoprostol before the operation than in those who received gemeprost (7 mm vs. 3 mm; p < 0.0001). The incidence of fever, vomiting and diarrhea was not different between the two groups. The incidence of abdominal pain with request for pain medication, emergency admission to operating room due to vaginal bleeding, hospital stay longer than 24 h and surgical repair of cervical injury due to Hegar dilatation was significantly higher among the gemeprost group than the misoprostol group.


CONCLUSIONS
In cervical priming prior to first-trimester pregnancy termination in nulliparous women, oral misoprostol is more effective and is associated with fewer side-effects and complications than intravaginal gemeprost.
Celentano
Claudio
C
Department of Obstetrics and Gynecology, San Massimo Hospital, Penne, Italy. ccelen@tin.it
Prefumo
Federico
F
Di Andrea
Osvaldo
O
Presti
Francesca
F
Di Nisio
Quirino
Q
Rotmensch
Sigi
S
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008499:Medical Records; D016595:Misoprostol / Q000008:administration & dosage*; D011183:Postoperative Complications; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; C021182:gemeprost; D000527:Alprostadil