Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion

Abstract

Vaginal pH influences the efficacy of misoprostol administered vaginally for the induction of midtrimester abortion. The presence of this relationship, despite premoistening misoprostol with an acidifying agent, suggests that the effect of vaginal pH might extend beyond affecting the pharmacokinetics of the drug.

The Effect of Vaginal pH on the Efficacy of Vaginal Misoprostol for the Induction of Midtrimester Pregnancy Termination

“…Thus, this study supports these reports because we only studied homogenous Iranian women. However, our observations are in contrast with those by AbdEl-Maeboud et al (11) and Yilmaz et al (12). In a study in Cairo, Abd-El-Maeboud et al reported that 3% acetic acid gel as adjuvant to misoprostol was more effective for midtrimester termination especially at vaginal pH values less than 5.…”

Impact of preoperative rectal misoprostol on blood loss during and after elective cesarean delivery

“…Studying the pharmacokinetics of misoprostol through assessment of its acid metabolite does not reflect the exact onset of action. For example, absorption and bioavailability of misoprostol after vaginal administration are affected by vaginal acidity and the bacterial microenvironment [14,15]. Sublingual misoprostol has the shortest onset of action, the highest peak concentration and the greatest bioavailability among all routes of administration, while oral route is associated with the highest incidence of side effects [16,17].…”

Randomized controlled study comparing misoprostol moistened with normal saline and with acetic acid for second‐trimester pregnancy termination. Is it different?

“…[2][3][4][5][6] To our best knowledge, only three studies involving misoprostol moistened with acetic acid for second-trimester pregnancy termination have been reported. [7][8][9] First, bd-El-Maeboud 7 showed that vaginal pH influences on the efficacy of misoprostol administered vaginally for induction of mid-trimester abortion and an acidifying agent, like acetic acid, can facilitate the absorption of misoprostol, resulting in a better outcome in terms of shorter abortion time and lower incidence of fever and abdominal pain. Second, Yilmaz et al 8 demonstrated that misoprostol moistened with acetic acid was significantly more effective than misoprostol moistened with saline.…”