Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2011

01-07-2011 | Materno-fetal Medicine

Randomized trial of oral versus sublingual misoprostol 24 h after mifepristone for medical abortion

Authors: Krishna Dahiya, Sonika Mann, Smiti Nanda

Published in: Archives of Gynecology and Obstetrics | Issue 1/2011

Login to get access

Abstract

Objectives

To assess the efficacy, side effects, and acceptability of medical abortion using oral mifepristone (200 mg) followed 24 h later by oral or sublingual misoprostol (400 μg).

Materials and methods

A total of 93 women with pregnancies up to 56 days of gestational age were assigned to two groups according to the different misoprostol regimen (group I 400 μg orally and group II 400 μg sublingually). The principle outcome measure was complete abortion defined as a complete expulsion of intrauterine contents without a need for surgical intervention 7 days after the procedure.

Results

Successful abortion occurred in 87.5% of patients in group 1 and 95.5% patients in group 2 (p = 0.166, 95% CI −0.194, 0.033). The patient acceptability and satisfaction rates were similar in both the groups.

Conclusion

It is concluded that 400 μg of sublingual misoprostol is as effective as oral misoprostol 24 h after mifepristone for medical abortion of ≤56 days.
Literature
1.
Saxena P, Salhan S, Sarda N (2004) Comparison between the sublingual and oral route of misoprostol for pre-abortion cervical priming in first trimester abortions. Hum Reprod 1(1):77–80CrossRef
2.
World Health Organization Task Force on Postovulatory Methods of Fertility Regulation (2000) Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomized trial. Br J Obstet Gynaecol 107:524–530CrossRef
3.
Tang OS, Chan C, Ng E, Lee S, Ho P (2003) A prospective, randomized, placebo-controlled trial on the use of mifepristone with sublingual or vaginal misoprostol for medical abortions of less than 9 weeks gestation. Hum Reprod 18(11):2315–2318PubMedCrossRef
4.
Schaff EA, Fielding SL, Westhoff C, Ellertson C, Eisinger SH, Stadalius LS (2000) Vaginal misoprostol administered 1, 2, or 3 days after mifepristone for early medical abortion. JAMA 284:1948–1953PubMedCrossRef
5.
von Hertzen H, Piaggio G, Marions L (2008) Comparison of two doses and two routes of administration of misoprostol after pre-treatment with mifepristone for early pregnancy termination. Reprod Health 5(2). doi:10.​1186/​1742-4755-5-2
6.
Vimala N, Mittal S, Kumar S (2004) Sublingual misoprostol before first trimester abortion: a comparative study using two dose regimens. Indian J Med Sci 58:54–61PubMed
7.
Spitz IM, Bardin CW, Benton L, Robbins A (1998) Early pregnancy termination with mifepristone and misoprostol in the United States. N Engl J Med 338:1241–1247PubMedCrossRef
8.
Tang OS, Schweer H, Seyberth HW, Lee SW, Ho PC (2002) Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod 17:332–336PubMedCrossRef
9.
Tang OS, Xu J, Cheng L, Lee SWH, Ho PC (2002) Pilot study on the use of sublingual misoprostol with mifepristone in termination of first trimester pregnancy up to 9 weeks of gestation. Hum Reprod 17:1738–1740PubMedCrossRef
10.
Hamoda H, Ashok PW, Flett GM, Templeton A (2005) A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation. BJOG 112:1102–1108PubMedCrossRef
11.
Creinin MD, Fox MC, Teal S, Chen A, Schaff EA, Meyn LA, MOD Study Trial Group (2004) A randomized comparison of misoprostol 6 to 8 hours versus 24 hours after mifepristone for abortion. Obstet Gynecol 103(51):851–859PubMedCrossRef
12.
Von Hertzen H, Honkanen H, Piaggio G, Bartfai G, Erdenetungalag R, Gemzell-Danielsson K (2003) WHO multinational study of three misoprostol regimens after mifepristone for early medical abortion. I: Efficacy. BJOG 110(9):808–818
13.
Guest J, Chien PFW, Thomson MAR, Kosseim ML (2007) Randomized controlled trial comparing the efficacy of same-day administration of mifepristone and misoprostol for termination of pregnancy with the standard 36 to 48 hour protocol. BJOG 114(2):207–215PubMedCrossRef
14.
Winikoff B, Dzuba IG, Creinin MD, Crowden WA, Goldberg AB, Gonzales J (2008) Two distinct routes of administration of misoprostol in mifepristone medical abortion: a randomized controlled trial. Obstet Gynecol 112(6):1303–1310PubMedCrossRef
15.
Schaff EA, Eisinger SH, Stadalius LS, Franks P, Gore BZ, Poppema S (1999) Low-dose mifepristone, 200 mg, and vaginal misoprostol for induced abortion. Contraception 59:1–6PubMedCrossRef
16.
Raghavan S, Comendant R, Digol I, Ungureanu S, Friptu V, Bracken H, Winikoff B (2009) Two pill regimens of misoprostol after mifepristone medical abortion through 63 days’ gestational age: a randomized controlled trial of sublingual and oral misoprostol. Contraception 7(2):84–90CrossRef
17.
Akin A, Dabash R, Dilbaz B, Aktun H, Dursun P, Kiran S, Aksan G, Dogan B, Winikoff B (2009) Increasing women’s choices in medical abortion: a study of misoprostol 400 μg swallowed immediately or held sublingually following 200 mg mifepristone. Eur J Contracept Reprod Health Care 14(3):169–175PubMedCrossRef
18.
Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V (2009) Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days. Contraception 80(3):282–286PubMedCrossRef
19.
Faucher P, Baunot N, Madelenat P (2005) The efficacy and acceptability of mifepristone medical abortion with home administration misoprostol provided by private providers linked with the hospital: a prospective study of 433 patients. Gynecol Obstet Fertil 33(4):220–227PubMedCrossRef
Metadata
Title
Randomized trial of oral versus sublingual misoprostol 24 h after mifepristone for medical abortion
Authors
Krishna Dahiya
Sonika Mann
Smiti Nanda
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 1/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1590-2

Other articles of this Issue 1/2011

Archives of Gynecology and Obstetrics 1/2011 Go to the issue

General Gynecology

Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women

Materno-fetal Medicine

A randomized controlled study investigating the necessity of routine cervical dilatation during elective cesarean section

General Gynecology

Effects of lumbar lordosis and pelvic inlet orientation on the outcome of the transobturator tape sling operation in women

Materno-fetal Medicine

Ultrasonography in pregnant women with antiphospholipid syndrome using salicylic acid and heparin

Gynecologic Oncology

Quality of life and toxicity in breast cancer patients using adjuvant TAC (docetaxel, doxorubicin, cyclophosphamide), in comparison with FAC (doxorubicin, cyclophosphamide, 5-fluorouracil)

Gynecologic Oncology

Inhibin/activin-betaC subunit does not represent a prognostic parameter in human endometrial cancer