Randomized comparison of 3 misoprostol protocols for abortion induction at 13-20 weeks of gestation.
OBJECTIVE
To evaluate the induction-to-abortion time of 3 pharmacokinetic-based protocols at 13-20 weeks of gestation.


METHODS
A randomized trial was conducted on 153 patients. The oral group (n = 51) received 100 microg misoprostol orally every 2 hours, the vaginal group (n = 51) received 200 microg misoprostol vaginally every 4 hours, and the sublingual group (n = 51) received 100 microg misoprostol sublingually every 2 hours.


RESULTS
The mean induction-to-delivery time was shorter in the sublingual group (mean, 651 +/- 507) as compared to the vaginal group (mean, 1,056 +/- 634, p = 0.01). The number of patients who delivered within 12 hours was significantly higher in the sublingual group (n = 39, 78%) as compared to the oral (n = 26, 52%) and vaginal (n = 20, 40%) groups (p < 0.001). The numbers of patients who delivered within 24 hours were comparable in the sublingual (n = 47, 94%) and oral (n = 46, 92%) groups but higher than in the vaginal group (n = 39, 78%; p = 0.02). The total misoprostol dose was 543 +/- 422 microg in the sublingual group, 878 +/- 533 microg in the vaginal group and 741 +/- 413 microg in the oral group (p < 0.001).


CONCLUSIONS
A pharmacokinetic-based application of 100 microg of sublingual misoprostol every 4 hours is more effective for induction of second-trimester abortion as compared to 100 microg oral misoprostol every 2 hours and 200 microg vaginal misoprostol every 4 hours.
Caliskan
Eray
E
Department of Obstetrics and Gynecology, Kocaeli University Faculty of Medicine and Social Security Council, Ankara, Turkey. eray68@hotmail.com
Dilbaz
Serdar
S
Doger
Emek
E
Ozeren
Semih
S
Dilbaz
Berna
B
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000284:Administration, Oral; D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol