A COMPARATIVE STUDY ON THE EFFICACY OF ORAL AND VAGINAL ADMINISTRATION OF MISOPROSTOL

Abstract

BACKGROUND: Different doses, routes and regimens of misoprostol for medical termination of pregnancy during second trimester have been studied for effective termination.. Misoprostol can be administered through various routes i-e orally, buccally, sublingually, rectally and vaginally. Objective of this study was to compare the efficacy of oral with vaginal misoprostol for termination of pregnancy in second trimester missed miscarriage.
METHODS: This Randomized Controlled Trial (RCT) was conducted in the Department of Obstetrics & Gynaecology, Combined Military Hospital, Rawalpindi from 1st October 2016 to 31st March 2017. A total of 152 women were sampled through non-probability consecutive sampling. Patients with 13-24 weeks gestation presenting to the antenatal clinic or emergency with missed miscarriage were included. Patients within complete miscarriage, retained products of conception and twin pregnancy were excluded. All selected cases were randomly divided into two groups. Women in group A received 400mcg of misoprostol orally whereas group B received 400mcg of misoprostol vaginally.
RESULTS: The mean age of women in group A was 28.04 ± 3.37 years and in group B was 30.18 ± 6.05 years.. Efficacy in Group A (oral misoprostol) was seen in 63 (82.89%) while in Group B (vaginal misoprostol) was seen in 41 (53.95%) patients (p = 0.0001).
CONCLUSION: This study concluded that efficacy of oral misoprostol is better as compared to vaginal misoprostol for termination of pregnancy in second trimester missed miscarriage.
KEYWORDS: Miscarriage, Second trimester, Misoprostol.