RETRACTED ARTICLE: Sublingual vs vaginal misoprostol for completion of first trimester missedabortion: a randomised controlled trial

Abdelshafy, Ahmed; Awwad, Hassan K.; Abo-Gamra, Amgad; Alanwar, Ahmed; Elkotb, A M; Shahin, Mohamed; El-Razek, Maya Abd; Abbas, Ahmed M.

doi:10.1080/13625187.2019.1569224

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…Our study agrees with previous studies conducted by Tanha et al, Soghra et al and Ahmed A et al who also demonstrated sublingual route of misoprostol as more effective compared to [16,17,18] vaginal route .…”

Section: Discussionsupporting

confidence: 93%

Comparison of Vaginal Misoprostol Versus Sublingual Misoprostol in First Trimester Medical Termination of Pregnancy

Mittal¹,

Arora

Mittal

2023

PIJR

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Medical termination of pregnancy for various indications was legalized in India in 1971.The NHM guidelines issued in the MMA handbook in 2016 recommends mifepristone 200mg and misoprostol 800 g for medical termination of pregnancy before 49 days from the last menstrual period. Misoprostol can be administered by oral, buccal, ublingual or vaginal route, with each route having its own advantages and disadvantages. We have conducted this study on 200 women desiring MTP to compare efficacy of vaginal and sublingual routes of administration of misoprostol. Our study concluded that sublingual misoprostol was more effective for early first trimester MTP compared to vaginal misoprostol.

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Section: Discussionsupporting

confidence: 93%

Comparison of Vaginal Misoprostol Versus Sublingual Misoprostol in First Trimester Medical Termination of Pregnancy

Mittal¹,

Arora

Mittal

2023

PIJR

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“…Misoprostol is an effective drug and safe while given trans-vaginally for inducing medical termination of pregnancy in second trimester of pregnancy. 13 interval was 14.64 hours, similar to our study results. 17 Previously a local study conducted in Bahawalpur (a city of Pakistan) reported success rate of 97.8% and failure rate of 2.2% among cases using misoprostol 4 hourly per vaginally, as compared to those using 6 hourly with success rate of 81.3% and failure rate of 18.7%.…”

Section: Discussionsupporting

confidence: 92%

Role of misoprostol 4 hourly versus 6 hourly in medical termination of pregnancy in 2nd trimester.

Devi¹,

Aftab²,

Reena³

et al. 2021

TPMJ

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Objective: To determine efficacy of misoprostol given in 4 hourly versus 6 hourly intervals in second trimester for termination of pregnancy. Study Design: Cross sectional study. Setting: Study was conducted at the department of Obstetrics and Gynecology of Jinnah Medical and Dental College Karachi Allied Hospital. Period: March to August 2020. Material & Methods: Pregnant ladies in second trimester, requiring abortion due to medical reasons, were planned for termination of pregnancy. Two groups were made. Patients in Group-A were given misoprostol 4 hourly and those in Group-B were given misoprostol 6 hourly. Similar dose of drug (200ug) was given in both groups and monitoring was done. If abortion done in 48 hours, it was considered effective abortion and if not happened in 48 hours, it was considered a failed abortion. Consent was taken from all ladies in study group. Ethical approval was taken from ethical review committee. Results: Total 140 cases were studied, 70 cases in each group, A & B. Age range of cases was 16-40 years with mean age of 26.4±3.5 years. Most of the cases were having age between 20-30 years (63.5%). Group-A (N=70) was given misoprostol 4 hourly, where abortion was done in 94.3% cases while abortion failed in 5.7% cases. In Group-B (N=70) misoprostol was given 6 hourly, induced abortion in 82.8% and failed in 17.1% cases. Conclusion: Misoprostol dose of 20ug given via vaginal route is much effective drug for medical termination of pregnancy when given 4 hourly instead 6 hourly, with low failure rate.

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“…The causes of MA are diverse and complex, including immune dysfunction (6), systemic infectious diseases (7), abnormal chromosome number or structure (8) and endocrine dysfunction (9). The innate immune-related nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome is a molecular platform that leads to excessive innate immune responses following activation by promoting the maturation of pro-inflammatory cytokines, such as IL-18 and IL-1β (10).…”

Section: Introductionmentioning

confidence: 99%

Pigment epithelium‑derived factor facilitates NLRP3 inflammasome activation through downregulating cytidine monophosphate kinase 2: A potential treatment strategy for missed abortion

Zhang

2020

Int J Mol Med

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A number of conditions may underlie the occurrence of missed abortion (MA), including inflammation. Pigment epithelium-derived factor (PEDF) is a novel mediator of the inflammation-related nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome, which is associated with several human diseases. However, the association between MA and NLRP3 inflammasome, and whether PEDF is reduced in MA, remain unknown. In the present study, the decidua and chorion tissues of patients who had suffered a MA were examined, and a lipopolysaccharide (LPS)-induced human chorionic trophoblast HTR8/SVneo cell model was established to mimic MA in vitro. The results revealed that cytidine monophosphate kinase 2 (CMPK2) expression and NLRP3 inflammasome activation, downstream pro-IL-18 and pro-IL-1β expression, and IL-18 and IL-1β release, were all significantly increased in MA tissues or LPS-induced HTR8/SVneo cells. PEDF reversed the increase in CMPK2 expression and activation of the NLRP3 inflammasome axis and, thus, downregulated the production of mitochondrial reactive oxygen species and mitochondrial dNA release, resulting in reduced lactate dehydrogenase release, and a resultant decrease in cell viability. Recovery of CMPK2 expression abolished all the effects of PEDF, indicating that CMPK2 may be an effector downstream of PEDF. PEDF reduced CMPK2 protein levels but did not affect the mRNA levels, and treatment with the proteasomal inhibitor MG132 significantly reversed this reduction in CMPK2 protein levels. Furthermore, a ubiquitination assay of immunoprecipitation demonstrated that CMPK2 was polyubiquitinated in the presence of LPS, PEDF and MG132. These results indicated that the NLRP3 inflammasome is implicated in the pathogenesis of MA, and PEDF may reduce MA through ubiquitin-dependent proteasomal degradation of CMPK2 to inhibit NLRP3 activation, which may serve as a novel strategy for preventing or reducing the risk of MA.

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RETRACTED ARTICLE: Sublingual vs vaginal misoprostol for completion of first trimester missedabortion: a randomised controlled trial

Cited by 7 publications

References 19 publications

Comparison of Vaginal Misoprostol Versus Sublingual Misoprostol in First Trimester Medical Termination of Pregnancy

Comparison of Vaginal Misoprostol Versus Sublingual Misoprostol in First Trimester Medical Termination of Pregnancy

Role of misoprostol 4 hourly versus 6 hourly in medical termination of pregnancy in 2nd trimester.

Pigment epithelium‑derived factor facilitates NLRP3 inflammasome activation through downregulating cytidine monophosphate kinase 2: A potential treatment strategy for missed abortion

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