A prospective, randomized comparison of vaginal misoprostol versus intra-amniotic prostaglandins for midtrimester termination of pregnancy.
OBJECTIVE
The purpose of this study was to compare the efficacy and adverse effects of vaginal misoprostol and intra-amniotic PGF2alpha for midtrimester abortion.


METHODS
One hundred thirty-two women between 12 and 24 weeks' gestation, seeking abortion in a tertiary hospital, were randomized to receive vaginal misoprostol (400 microg every 3 hours) or intra-amniotic PGF2alpha (carboprost 1.5 mg). Main outcome measures were induction-to-abortion interval, success rates at 24 and 48 hours, and adverse effects.


RESULTS
Successful abortion rates at 24 and 48 hours between intra-amniotic PGF2alpha and vaginal misoprostol were not statistically different. However, vaginal misoprostol results in a significantly shorter mean induction-to-abortion interval, compared with intra-amniotic PGF2alpha (misoprostol: 16.2 hours; intra-amniotic PGF2alpha: 20.8 hours; P = .006), particularly among multiparous women (misoprostol: 13.1 hours; intra-amniotic PGF2alpha 18.3 hours; P = .011) and for gestation below 130 days (misoprostol: 14.6 hours; intra-amniotic PGF2alpha: 20.2 hours; P = .015). Fever and shivering were commoner with vaginal misoprostol.


CONCLUSIONS
Vaginal misoprostol should be the regimen of choice for midtrimester abortion, particularly for multiparous women and women in the early second trimester.
Su
Lin-Lin
LL
Department of Obstetrics and Gynaecology, National University Hospital, Singapore. obgv9@nus.edu.sg
Biswas
Arijit
A
Choolani
Mahesh
M
Kalaichelvan
Vanaja
V
Singh
Kuldip
K
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000653:Amniotic Fluid; D002260:Carboprost / Q000008:administration & dosage*; D015237:Dinoprost / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011446:Prospective Studies; D011453:Prostaglandins / Q000008:administration & dosage*; D014621:Vagina
D000020:Abortifacient Agents, Nonsteroidal; D011453:Prostaglandins; D016595:Misoprostol; D002260:Carboprost; D015237:Dinoprost