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. 2011 Apr;43(2):172-5.
doi: 10.4103/0253-7613.77356.

Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion

Shagufta Parveen  1 , Zaffar Abbas Khateeb, S M Mufti, M A Shah, Vishal R Tandon, S Hakak, Z Singh, Shagufta Yasmeen, Shakeel A Mir, Rehana Tabasum, Nasreen Jan
Affiliations

Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion

Shagufta Parveen et al. Indian J Pharmacol. 2011 Apr.

Abstract

Objectives: To compare the effectiveness and tolerability of misoprostol as a cervical ripening agent in first trimester abortion through three different routes of administration before surgical evacuation (SE).

Materials and methods: It was a hospital based prospective randomized open labeled parallel study. A total of 150 randomly selected married women were divided in three groups for sublingual (S/L), vaginal and oral 400 μg of misoprostol single dose administration. The drug was administered 3-4 h before SE in the S/L and vaginal groups and 12 h before the procedure in the oral group. Efficacy was assessed on the basis of time taken for ripening, dilatation achieved, duration of the procedure, intra-operative blood loss, and pain score. The tolerability was noted on the basis of side effects.

Results: The mean time taken for cervical ripening was less in sublingual administration (3.7±1.2 hr) as compared to the vaginal and oral routes. The S/L group had significant cervical dilatation (P<0.001) and the duration of SE was less as compared to the vaginal and oral routes. However, the mean intraoperative blood loss was more in sublingual as compared to the vaginal and oral groups. The intra-operative pain score of the S/L group was significantly lower (1.9±1.1, P<0.05) as compared to the vaginal (2.6±1.7) or oral route (3.3±1.7). Loose motions and nausea/vomiting were more with the S/L and oral routes while blood loss was more in the vaginal route.

Conclusion: Administration of misoprostol by the sublingual route is better than the oral and vaginal routes for cervical ripening.

Keywords: Cervical ripening; first trimester abortion; misoprostol; surgical evacuation.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT statement of the study
Figure 2
Figure 2
Cervical ripening in the studied subjects (n)
Figure 3
Figure 3
Dilation (mm) achieved with single dose in the studied subjects
Figure 4
Figure 4
Duration of procedure (min) in the studied subjects
Figure 5
Figure 5
Intra operative blood loss (ml) in the studied subjects
See this image and copyright information in PMC

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