Early pregnancy termination with intravaginally administered sodium chloride solution-moistened misoprostol tablets: Historical comparison with mifepristone and oral misoprostol

OBJECTIVE: The purpose of this study was to compare the abortifacient effec t of intravaginally administered moistened misoprostol tablets with that of the combination regimen of mifepristone and oral misoprostol. STUDY DESIGN: One hundred women at less than or equal to 56 days' gestation received 800 mu g misoprostol intravaginally in the form of sodium chlorid e solution-moistened tablets. The dose was repeated 24 hours later if a ges tational sac persisted on ultrasonographic examination. These 100 subjects (group 1) were then matched with 100 subjects who had received 600 mg mifep ristone followed by 400 mu g misoprostol orally as part of a large multicen ter American trial (group 2). Subjects were monitored for abortion success, adverse side effects, and bleeding characteristics. Abortion failure was d efined as persistence of an intrauterine sac or the need to perform a surgi cal evacuation of the uterus for hemorrhage, far incomplete abortion, or at the subject's request. RESULTS: In 88 of the 100 women in group 1 and 94 of the 100 women in group 2, abortion occurred and a surgical procedure was not required. Abortion r ates were not influenced by gestational age in either group. Prostaglandin- related side effects of fever and chills, vomiting, diarrhea, and uterine p ain were all significantly higher in group 1. Excessive uterine bleeding wa s uncommon in both groups, and no subjects received blood transfusions. CONCLUSION: The abortion rate with intravaginally administered moistened mi soprostol tablets is similar to that with the combination of mifepristone a nd oral misoprostol. However, intravaginal administration of misoprostol is associated with significantly more prostaglandin-related side effects.