Comparison of Efficacy and Safety of Two Different Doses of Sublingual Misoprostol 400?g AND 200?g with Vaginal Misoprostol 400?g in Cervical Ripening in First Trimester Abortion

Dr. K. Preethi

Abstract: Despite wider availability of contraception methods, the incidence of induced abortion is increasing. Cervical priming prior to first trimester abortion facilitates the procedure and reduces the risk of cervical injury and uterine perforation that are often associated with mechanical cervical dilatation. The main objective of the study is to compare the efficacy of two different doses of sublingual misoprostol 200 ?g and 400 ?g with vaginal misoprostol 400 ?g in cervical ripening in women undergoing first trimester abortion. An open label, randomized, prospective study was done in family planning inpatient department in MGMH, Hyderabad.120 pregnant women with < 12 wks of gestation requiring suction evacuation for first trimester abortion were enrolled and divided into three groups of 40 each. Groups 1, 2, 3 received misoprostol 400?g vaginally, 400?g sublingually, 200?g sublingually respectively. After 5 hrs of administration the cervical dilatation was measured and suction evacuation was done. Misoprostol 400 ?g showed no difference in efficacy when administered by vaginal and sublingual routes. Cervical dilatation was more with sublingual misoprostol 400 ?g compared to sublingual misoprostol 200 ?g, though there was no significant difference in initiating the process of abortion. Sublingual route is preferred because of easy availability and patient's acceptability. Sublingual misoprostol 200 ?g can be preferred to 400 ?g as it is associated with less side effects.

Keywords: misoprostol, abortion, cervical dilatation, sublingual route, vaginal route