A randomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy between 13 to 20 weeks

Bhattacharjee, Nabendu; Saha, Shyama Prasad; Ghoshroy, Samir Chandra; Bhowmik, Sabyasachi; Barui, Gangotri

doi:10.1111/j.1479-828x.2008.00831.x

Cited by 32 publications

(33 citation statements)

References 18 publications

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“…Drug related side effects and procedure related complications were very low, which is comparable to different studies. 9,13,15 In present prospective study 98% women aborted within 16 hours, which is comparable to about ninety percent as reported by other studies.…”

Section: Discussionsupporting

confidence: 77%

“…Mean induction abortion interval in our study was 12.58±1.02 hours which is comparable to 12-16 hours in other studies and with better induction to interval time. [12][13][14][15] Thus, vaginal dinoprostone gel with misoprostol is found to be an efficient and time saving drug for second trimester pregnancy termination. These drugs are easily available in any obstetric unit.…”

Section: Discussionmentioning

confidence: 99%

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Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

Kumar¹,

Agarwal

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONSecond trimester termination contributes approximately 10% to 20% of all induced abortions cases and about 65% to 70% of all fatal complications are related to induced abortions. Various agents are used to ripen the cervix and stimulate uterine contractions and induce abortion after 12 weeks, but available data regarding their safety and effectiveness are limited.1,2 Various agents include hypertonic saline, or hyperosmolar urea, injected intra-amniotically; ethacridine lactate administered intraor extra-amniotically; prostaglandin analogues administered parenterally or intra-or extra-amniotically; and oxytocin injected intravenously or intramuscularly. These methods and routes of administration, however, are invasive and likely to be less safe, and the time to complete abortion is longer when compared to the use of methods such as misoprostol alone, combined dinoprostone and misoprostol combined mifepristone and misoprostol.2-5 Second trimester abortion also includes surgical procedure, but it can result in complications like uterine perforation, cervical incompetence, uterine ABSTRACT Background: The addition of dinoprostone gel (PGE2) to standard regimen of second trimester abortion using vaginal misoprostol (PGE1) reduces failure rate and decrease induction abortion time interval. We evaluated the role and efficacy of vaginal dinoprostone gel with vaginal misoprostol in women undergoing second trimester abortion. Objective of present study was to assess the safety and effectiveness of vaginal dinoprostone gel plus vaginal misoprostol for second trimester termination of pregnancy. Methods: This study was a prospective cohort involving 100 women with 12-20 weeks gestation requesting termination of pregnancy. In study group 0.5mg dinoprostone gel applied vaginally followed by 400µg misoprostol every four hourly (max 3 doses) after six hours of dinoprostone gel application. The mean age of the women study was 27.2 years and mean gestational age was 18.9 weeks. The primary effectiveness of the study was the efficacy of the treatment to terminate pregnancy at 20 hrs. Secondary outcomes were induction abortion interval, failure rate, side effects. statistical analysis of study was carried out using chi square test. Results: At 20 hours, the complete abortion rate was 100%. Within 16 hours 98% women aborted without any significant side effects. Mean induction abortion interval was 14.56 hours. Conclusions: Combination of vaginal dinoprostone gel (PGE2) plus misoprostol (PGE1) is effective, safe and alternate method for second trimester pregnancy termination with. In this protocol induction to abortion interval time is less as compared to other methods of second trimester pregnancy termination.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

Kumar¹,

Agarwal

2018

Int J Reprod Contracept Obstet Gynecol

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“…This is in accordance to study by Tang et al 16 in which success rate was 91% for sublingual group and 95% for pervaginal group. Also Bhattacharjee et al 17 found success rate of 79% and 82% respectively in the sublingual and pervaginal groups and was statistically insignificant. Tanha et al 18 found the success rate of 61% in the pervaginal group and 70% in the sublingual group which was statistically insignificant.…”

Section: Discussionmentioning

confidence: 92%

“…This result corresponds with earlier study done by Tang et al 16 where in the sublingual group the interval was 13.2 hours and in the pervaginal group was 12 hours and the two values were also statistically insignificant. Bhattacharjee et al 17 found induction -abortion interval to be 14.1 and 14.5 hours in the sublingual and pervaginal groups respectively and was statistically insignificant.…”

Section: Discussionmentioning

confidence: 92%

A comparison of intravaginal misoprostol with sublingual misoprostol for second trimester medical termination of pregnancy

Pandey¹,

Kundu²,

Deshmukh³

2015

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONSafe and legal abortion is considered to be a key intervention for improving women's health and quality of life.1 In our country a significant number of women practice contraception but Medical Termination of Pregnancy (MTP) is also used to control family size and birth spacing.2 As a result, an overwhelming proportion of induced abortions (6.7 million annually-an indirect estimate) take place in India 3 and elective termination of pregnancy is considered as a commonly performed gyanecological procedure. 4 Second trimester abortions constitute 10-15% of all induced abortions worldwide, but are related to twothirds of major abortion related complications.5 During the last decade, medical methods for second trimester induced abortions have has considerably improved and became safe and more accessible.Although several methods have been tried over the years with varying success, the ideal method for mid-trimester abortion remains elusive, as indicated by the constant search for new methods. [5][6][7][8][9] Ethacridine lactate has a long history of use in our country and is recommended for use ABSTRACTBackground: Second trimester abortions generally account for less number of patients as compared to first trimester abortions as patients generally come earlier as soon as pregnancy is recognized but now days due to advent of USG many cases of fetal anomaly are detected earlier accounting for increasing number of cases of second trimester. Methods: Present study was conducted among patients with pregnancy between 13-20 weeks of period of gestation (to be randomly assigned) after getting approval from institutional ethics committee and informed consent from the patient. Participants were randomly allocated to receive 400 µg of misoprostol either sublingually or intravaginally every six hours for a maximum of 5 doses. The blood pressure, pulse rate & temperature and side effects monitored every 3 hrs. If women in either group failed to abort after 48 hours of initiation of treatment termed as failure. In cases of failure they were given additional doses of sublingual misoprostol till abortion occurred. Primary outcome variable compared was success rate at 48 hours. Secondary outcome variables compared were bleeding patterns, completeness of abortion, induction abortion interval and any side effects. Results: It has been found that vaginal misoprostol 400 micro gm achieved a success rate to 100% in 48 hours, while the success rate was 93.33% with the sublingual route. (P = 0.4915, NS). Conclusions: Thus from our limited study population, we conclude that there is no significant difference in efficacy and complications between the two routes, although a larger cohort is required to get more dependable result.

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“…In the same author study, sublingual misoprostol in gestational age <12 weeks reported success rate of about 86%. 9 Helena et al 11 demonstrated that repeated administration of 400 µg Misoprostol either vaginally or sublingually is an effective and acceptable option. However vaginal administration appears to produce better results among multiparous women, but more women had fever >38C in Vaginal route.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of sublingual and vaginal misoprostol in second trimester induced abortion

Jogi

2015

Int J Reprod Contracept Obstet Gynecol

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A randomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy between 13 to 20 weeks

Abstract: Both sublingual and vaginal administrations of misoprostol are equally effective in inducing medical abortion during second trimester but sublingual route was preferred by the patients.

Cited by 32 publications

References 18 publications

Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

Role and efficacy of vaginal dinoprostone gel (PGE2) plus vaginal misoprostol (PGE1) in second trimester termination of pregnancy

A comparison of intravaginal misoprostol with sublingual misoprostol for second trimester medical termination of pregnancy

Comparative study of sublingual and vaginal misoprostol in second trimester induced abortion

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