A prospective randomised comparison of sublingual and vaginal misoprostol in second trimester termination of pregnancy.
OBJECTIVE
To compare the efficacy, side effects and acceptability of sublingual and vaginal misoprostol for second trimester medical abortion.


METHODS
Prospective randomised controlled trial.


METHODS
Tertiary referral unit and a teaching hospital.


METHODS
Two hundred and twenty-four women at 12 to 20 weeks of gestation.


METHODS
The women were randomised to receive either sublingual or vaginal misoprostol 400 microg every 3 hours for a maximum of five doses. The course of misoprostol was repeated if the woman did not abort within 24 hours.


METHODS
The success rate at 48 hours, induction-to-abortion interval and the side effects.


RESULTS
There was no significant difference in the success rate at 48 hours (sublingual: 91%; vaginal: 95%). However, the success rate at 24 hours was significantly higher in the vaginal group (85%) compared with the sublingual group (64%). There was no difference in the median induction-to-abortion interval (sublingual: 13.8 hours; vaginal: 12.0 hours). Significantly more women in the sublingual group preferred the route to which they were assigned when compared with the vaginal group. The incidence of fever was also less in the sublingual group.


CONCLUSIONS
The use of vaginal misoprostol for second trimester medical abortion resulted in a higher success rate than sublingual misoprostol at 24 hours but the abortion rate was similar at 48 hours. Vaginal misoprostol should be the regimen of choice but sublingual misoprostol is also an effective alternative.
Department of Obstetrics and Gynaecology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Oi Shan
OS
Tang
Winnie Nga Ting
WN
Lau
Carina Chi Wai
CC
Chan
Pak Chung
PC
Ho
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D000328:Adult; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol