A COMPARISON BETWEEN 2 DOSES OF INTRAVAGINAL MISOPROSTOL AND GEMEPROST FOR INDUCTION OF 2ND-TRIMESTER ABORTION

Objective: To compare the abortifacient efficacies of two intravaginal ly administered misoprostol doses and gemeprost in termination of seco nd-trimester pregnancy. Methods: Eighty-one women between 12 and 24 we eks' gestation requesting abortion were randomized to receive intravag inally either 100 mu g of misoprostol at 6-hour intervals (n = 27), 20 0 mu g of misoprostol at 12-hour intervals (n = 26), or 1.0 mg of geme prost at 3-hour intervals (n = 28). The regimen was continued until ab ortion, or for 36 hours, with assessment of the rate of complete and i ncomplete abortions as well as side effects within 48 hours from the s tart of the treatment. Results: The final rates of terminations were 7 4% in the 100-mu g misoprostol group, 92% in the 200-mu g misoprostol group, and 89% in the gemeprost group. Abortion was complete in 37%, 6 1%, and 32% in each group, respectively (P = .03, when the 200-mu g mi soprostol group was compared with the two other groups). The induction -to-abortion interval was longer (P = .001) in the misoprostol groups (mean 23.1 hours for the 100-mu g and 27.8 hours for the 200-mu g dose ) than in the gemeprost group (14.5 hours). There was less pain (P = . 01), diarrhea (P = .001), and vomiting (P = .01) in the misoprostol gr oups than in the gemeprost group. The mean blood loss in the misoprost ol groups was lower than in the gemeprost group (P = .001). Conclusion s: Intravaginal application of 200 mu g of misoprostol at 12-hour inte rvals in induction of second-trimester abortion is equally effective t o a standard gemeprost regimen. Misoprostol causes fewer side effects and is cheaper and more practical to use. (C) 1997 by The American Col lege of Obstetricians and Gynecologists.