Comparison of four perioperative misoprostol regimens for surgical termination of first-trimester pregnancy.
OBJECTIVE
To compare the outcomes of 4 different perioperative misoprostol regimens for surgical termination of first-trimester pregnancy.


METHODS
Retrospective analysis of the records of 4000 women (4 cohorts of 1000 each) who underwent surgical termination of pregnancy. The 4 cohorts received: no misoprostol; 200 microg of oral misoprostol 30 minutes preoperatively; 200 microg of sublingual misoprostol 30 minutes preoperatively; or 200 microg of oral misoprostol 3 hours preoperatively plus 200 microg of vaginal misoprostol postoperatively. Adverse effects of the last regimen were surveyed in 1000 women.


RESULTS
In the cohorts that received misoprostol, the difficulty of cervical dilatation was reduced (P<0.001) compared with the cohort of women that did not receive misoprostol. The frequency with which women made postoperative contacts with the clinic was also reduced in the cohorts that received misoprostol (P<0.05). Adverse effects were minimal.


CONCLUSIONS
This retrospective study showed an association between perioperative administration of misoprostol, reduced difficulty for operators, and reduced demand for postoperative care. The regimen associated with the greatest reduction in difficult cervical dilatations and postoperative consultations was 200 microg of oral misoprostol 3 hours preoperatively plus 200 microg of misoprostol vaginally at the end of the surgical procedure.
Chambers
Dennis G
DG
The Queen Elizabeth Hospital Pregnancy Advisory Centre, Woodville Park, Adelaide, South Australia. dennis.chambers@health.sa.gov.au
Mulligan
Ea C
EC
Laver
Anthony R
AR
Weller
Bronwen K
BK
Baird
Jane K
JK
Herbert
Wye Y
WY
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D019990:Perioperative Care; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D014619:Vacuum Curettage
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol