Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion

Parveen, Shagufta; Khateeb, Zaffar Abbas; Mufti, Shahida Masarat; Shah, Milind; Tandon, Vishal R; Hakak, Sheeba; Singh, Zorawar; Mir, Shakeel Ahmad; Tabasum, Rehana; Jan, Nasreen

doi:10.4103/0253-7613.77356

Cited by 13 publications

(3 citation statements)

References 13 publications

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“…Parveen et al concluded that sublingual misoprostol is an effective and favorable cervical ripening agent for first trimester abortion as compared to vaginal and oral dosage forms ( 17 ). Some limitations included in this research; Lack of willingness of patients to choose medical approach of treatment os it is very slow in comparison with the surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Sublingual and Vaginal Route of Misoprostol in Management of First Trimester Miscarriage Missing

2016

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Background:Each year, more than forty million abortions are occurred whole of the world. Misoprostol is a prostaglandin analogue with a strong uterotonic effect. The present study aimed to compare the efficacy of Misoprostol in first trimester abortion through two sublingual and vaginal routes of administration.Methods:This randomized clinical trial was conducted on 52 consecutive women in first trimester candidate for pregnancy termination because of fetal IUFD or missed abortion in sonography reports. The patients were hospitalized and then randomly assigned to receive sublingual Misoprostol (400 µg, n 27) or vaginal Misoprostol (400 µg placed in posterior fornix, n = 25).Findings:None of the pregnant in the sublingual group developed complete abortion at the end of follow-up time, while 36% of women inducted with vaginal misoprostol experienced complete abortion indicating a intergroup significant difference (p = 0.001). Compared with vaginal group, those women in sublingual group experienced more complications including diarrhea (22.2% versus 20.0%), nausea and vomiting (22.2% versus 0.0%), and abdominal pain (3.7% versus 0.0%).Conclusion:The use of Misoprostol in vaginal route results in more abortion completeness as well as lower complication rate as compared to sublingual prescription of the drug.

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Section: Discussionmentioning

confidence: 99%

Comparison Between Sublingual and Vaginal Route of Misoprostol in Management of First Trimester Miscarriage Missing

2016

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“…Regarding the time that the misoprostol give the complete abortion, in our study, mean ± STD was 20.7 ± 28.2h which was very close to the systemic review conducted in 2017 by Wu et al [ 11 ] In 2011, a published study confirmed that the administration of misoprostol by the sublingual route is better than the oral and vaginal routes for cervical ripening. [ 12 ] The mean length of hospital stay for women who took misoprostol in our study was 3.0 ± 2.9h. A study compared between the oral and vaginal misoprostol regarding length of hospital stay and they found no statistical significant difference between two mean (hours).…”

Section: Discussionmentioning

confidence: 78%

Retrospective Study on the Pattern of Off-label Use of Misoprostol in Tabuk, Saudi Arabia

Alharthi

Alsaeed

Alsharif

et al. 2021

Journal of Pharmacy and Bioallied Sciences

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A BSTRACT Introduction: Off-label drug use (OLDU) refers to the prescription of a currently available and marketed medication for a use that has never been approved by the Food and Drug Administration (FDA). Misoprostol is one of the drugs which is used off-label. This drug, authorized for the treatment or prevention of peptic ulcers and other stomach disorders, is commonly used off-label for inducing labor or intrauterine device insertion. This research focuses on identifying the percentage of morbidity and mortality by off-label use of misoprostol; classifying the most common off-label misoprostol use in Tabuk hospitals; and determining the availability of policy and procedures behind prescribing the off-label misoprostol. Materials and Methods: Retrospective observational study was carried out. Data were collected from patients’ files for those admitted to the maternity wards in Tabuk Hospitals from March 2019 until September 2019. Results: Approximately 53% of cases were diagnosed with missed abortion. The mean time for abortion after administering misoprostol was 20.7 ± 28.2h. About 76% of women had an indication of bleeding. Guidelines were not followed with respect to dosage regimen. The mean of hospital stay was 3 days. There were no significant complications associated with the administration of misoprostol. Conclusion: There is no policy and procedure available in the hospital regarding off-label use of misoprostol. Moreover, physicians have low adherence to the guideline in terms of dosage, interval, and route of administration for each indication in obstetrics and gynecology.

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“…Dorr et al [ 19 ] also reported that the proportion of women who experienced uterine tachysystole or chorioamnionitis did not significantly differ by route of administration. Perveen et al [ 20 ] compared oral, sublingual, and vaginal misoprostol for cervical ripening for first-trimester abortion. The sublingual group had significant cervical dilatation, and the side effects were less as compared to the vaginal and oral routes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy and Safety of Sublingual Versus Oral Misoprostol for the Induction of Labor: A Randomized Open-Label Study

Datta,

Ghosh,

AyazAhmed Kharodiya

2023

Cureus

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Introduction Misoprostol (prostaglandin E1 analog) is being used for the induction of labor by vaginal, oral, and sublingual routes. Oral misoprostol is the preferred route for induction of labor, but the use of sublingual misoprostol appears promising due to a faster onset of action. This study was done to compare the efficacy and safety of oral and sublingual misoprostol for induction of labor in term pregnancy. Materials and methods One hundred and sixty patients were randomly allocated to one of the two groups to receive 50 micrograms of oral and sublingual misoprostol four hourly for a maximum of six doses. Primigravida at 37-42 weeks of gestation with singleton pregnancy, cephalic presentation, Bishop score (<5), and reassuring fetal heart rate were included in the study. Misoprostol dose was withheld if the active phase of labor was reached or if the cervix was favorable for amniotomy (Bishop score greater than or equal to eight). The change in the Bishop score with misoprostol was studied along with adverse effects and neonatal outcomes. Results The mean number of 50 mcg misoprostol doses required was significantly less in the sublingual group (2.94±0.97 versus 2.13±0.92; p<0.0001). The rate of change of the mean Bishop score was faster in the sublingual group. After four hours of the first dose, the mean Bishop score changed to 3.52±2.14 versus 4.68±2.34 (p=0.001), and, similarly, after eight hours, it was 10.48±2.59 versus 11.39±2.06, and this difference was statistically significant (p=0.015). The mean induction delivery interval was significantly lower in the sublingual group. The need for labor augmentation, mode of delivery, and adverse effects were similar in both groups. The incidence of meconium-stained liquor and NICU admission was also similar in both groups. Conclusion Sublingmisoprostolstol has a short induction delivery interval and comparable side effects when compared to omisoprostolstol. Sublingmisoprostolstol is recommended for induction of labor at term.

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Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion

Cited by 13 publications

References 13 publications

Comparison Between Sublingual and Vaginal Route of Misoprostol in Management of First Trimester Miscarriage Missing

Comparison Between Sublingual and Vaginal Route of Misoprostol in Management of First Trimester Miscarriage Missing

Retrospective Study on the Pattern of Off-label Use of Misoprostol in Tabuk, Saudi Arabia

Comparison of the Efficacy and Safety of Sublingual Versus Oral Misoprostol for the Induction of Labor: A Randomized Open-Label Study

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