Effectiveness of 400 or 600 micrograms of vaginal misoprostol for terminations of early pregnancies

Abstract

Objectives: To compare the effectiveness and side effects of transvaginal application of 400 or 600 ug of misoprostol for termination of pregnancy.

Study design: A prospective randomized single-blinded trial.

Setting: Department of Obstetrics & Gynecology, Bhumibol Adulyadej Hospital.

Material and method: One-hundred-and-twenty-five pregnant women with less than 20 weeks gestational, at Bhumibol Adulyadej Hospital from June 1, 2003 to May 31, 2004 were recruited. The termination of pregnancy had been suggested by the obstetrician and the decision was made by the patient and her husband. The samples were randomized into 2 groups. Group 1 had 65 patients and 400 ug of misoprostol was applied three times in a 6 hour interval. Group 2 had 60 patients and 600 ug of misoprostol was applied in the same manner. Both groups were observed and evaluated within 24 hours.

Main outcome measures: Rate of complete abortion and side effects of both 400 and 600 microg misoprostol within 24 hours.

Results: No statistical significant difference was found in the general characteristics of both sample groups. Group 1 had an abortion rate of 38.3% while group 2 had an abortion rate of 56.92%. This was statistically significant (p < 0.05). The time interval after insertion to complete abortion was 9.15 +/- 6.09 hours in group 1 and 8.85 +/- 4.68 hours in group 2. Side effects, such as fever, lower abdominal pain, massive vaginal bleeding and diarrhea showed no statistical difference (p > 0.05).

Conclusion: Transvaginal application of 600 ug misoprostol (3 times every 6 hours) caused a higher rate of complete abortion compared with an application of 400 ug misoprostol. The side effect of both groups showed no statistical difference.