VAGINAL MISOPROSTOL COMPARED WITH ORAL MISOPROSTOL IN TERMINATION OF 2ND-TRIMESTER PREGNANCY

Objective: To compare the efficacy of vaginal with oral misoprostol in termination of second-trimester pregnancy after pretreatment with mif epristone. Methods: Women requesting termination of trimester pregnanc y were randomized into two Thirty-six to 48 hours after oral administr ation of 200 mg of mifepristone, women were given either oral or vagin al misoprostol 200 mu g every 3 hours for a maximum of five doses in t he first 24 hours. Women receiving oral misoprostol also were given a vaginal placebo (vitamin B6), whereas those receiving vaginal misopros tol were given an oral placebo. If they failed to abort, a second cour se was given by the same route. Results: The median induction-abortion interval in the vaginal group (9 hours) was significantly shorter tha n that in the oral group (13 hours). The percentage of women aborting within 24 hours in the vaginal group (90%) was significantly higher th an that in the oral group (69%). The median amount of misoprostol used in the vaginal group (600 mu g) also was significantly less than that in the oral group (1000 mu g). There was no significant difference in the incidence of side effects between the two groups except for fatig ue and breast tenderness, which were more common in the oral group. Se venty-six percent of the women preferred the oral route, and 24.5% of the women preferred the vaginal route. Conclusion: Vaginal misoprostol is more effective than oral misoprostol in termination of second-trim ester pregnancy after pretreatment with mifepristone, but more women p referred the oral route. (C) 1997 by The American College of Obstetric ians and Gynecologists.