title: Randomized trial of buccal versus vaginal misoprostol for induction of second trimester abortion.
abstract: BACKGROUND
  We evaluated the efficacy and acceptability of repeat doses of buccal misoprostol compared to vaginal misoprostol for second trimester pregnancy termination by induction.
  
  
  METHODS
  Women requesting termination of a pregnancy between 18 and 22 weeks gestation were approached for participation. All women received 400 mcg misoprostol vaginally on admission. Participants were randomized to receive subsequent doses of 200 mcg misoprostol every 6 h either buccally or vaginally. All participants completed an acceptability survey.
  
  
  RESULTS
  Sixty-four women participated. The mean gestational age was 19.7 weeks. The median time to abortion in the buccal group was 15 h, which was not significantly different (p=0.44) from the vaginal-only group of 12 h. Most women in both groups preferred their allocated administrative route.
  
  
  CONCLUSIONS
  Repeat doses of buccal misoprostol are as effective as vaginal misoprostol in inducing abortions in the midtrimester and are highly acceptable to most women. It is reasonable to offer both options to women.
authors.affiliation: Boston University Medical Center, Boston University, Boston, MA 02118, USA. sacheen.carrellis@bmc.org
authors.forename: Sacheen Carr
authors.initials: SC
authors.lastname: Ellis
authors.forename: Nathalie
authors.initials: N
authors.lastname: Kapp
authors.forename: Olivera
authors.initials: O
authors.lastname: Vragpvoc
authors.forename: Lynn
authors.initials: L
authors.lastname: Borgata
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol