A prospective, randomized comparison of vaginal misoprostol versus intra-amniotic prostaglandins for midtrimester termination of pregnancy

Abstract

Objective: The purpose of this study was to compare the efficacy and adverse effects of vaginal misoprostol and intra-amniotic PGF2α for midtrimester abortion. Study design: One hundred thirty-two women between 12 and 24 weeks' gestation, seeking abortion in a tertiary hospital, were randomized to receive vaginal misoprostol (400 μg every 3 hours) or intra-amniotic PGF2α (carboprost 1.5 mg). Main outcome measures were induction-to-abortion interval, success rates at 24 and 48 hours, and adverse effects. Results: Successful abortion rates at 24 and 48 hours between intra-amniotic PGF2α and vaginal misoprostol were not statistically different. However, vaginal misoprostol results in a significantly shorter mean induction-to-abortion interval, compared with intra-amniotic PGF2α (misoprostol: 16.2 hours; intra-amniotic PGF 2α: 20.8 hours; P = .006), particularly among multiparous women (misoprostol: 13.1 hours; intra-amniotic PGF2α 18.3 hours; P = .011) and for gestation below 130 days (misoprostol: 14.6 hours; intra-amniotic PGF2α: 20.2 hours; P = .015). Fever and shivering were commoner with vaginal misoprostol. Conclusion: Vaginal misoprostol should be the regimen of choice for midtrimester abortion, particularly for multiparous women and women in the early second trimester. © 2005 Elsevier Inc. All rights reserved.