Sublingual versus vaginal misoprostol (400 microg) for cervical priming in first-trimester abortion: a randomized trial

Contraception. 2006 Oct;74(4):328-33. doi: 10.1016/j.contraception.2006.03.031. Epub 2006 May 23.

Abstract

Objective: Our objective was to compare the sublingual administration and the vaginal administration of misoprostol for cervical priming before first-trimester surgical abortion.

Design: We used an open, multicenter, randomized trial.

Locations: We conducted the study in four clinics (in Valencia, Castelló, Murcia and Murcia Capital) in Spain.

Participants: A total of 1424 healthy pregnant women with amenorrhea of <or=84 days who voluntarily decided to terminate their pregnancy participated in the study.

Methods: Women were randomly assigned to receive a single dose of 400 microg of misoprostol either sublingually or vaginally 1-3 h before aspiration.

Outcome measures: The outcome measures assessed were cervical dilation before surgery and surgical time needed for aspiration. The incidence of side effects, such as nausea, vomiting, diarrhea, fever/chills and paresthesia, was evaluated.

Results: The mean cervical dilation achieved was 6.8+/-0.8 and 6.7+/-0.9 mm for the sublingual and vaginal groups, respectively. The mean surgical time was 7.0+/-2.8 and 7.4+/-2.5 min for the sublingual and vaginal groups, respectively. Nausea, vomiting and diarrhea were more frequent in the sublingual group.

Conclusions: Both regimens had equal efficacy; however, the sublingual route caused more side effects.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Abortifacient Agents, Nonsteroidal / administration & dosage
  • Abortifacient Agents, Nonsteroidal / adverse effects
  • Abortion, Induced / methods*
  • Administration, Intravaginal
  • Administration, Sublingual
  • Adult
  • Cervical Ripening / drug effects*
  • Drug Administration Routes
  • Female
  • Humans
  • Misoprostol / administration & dosage*
  • Misoprostol / adverse effects
  • Pregnancy
  • Pregnancy Trimester, First / drug effects*
  • Treatment Outcome

Substances

  • Abortifacient Agents, Nonsteroidal
  • Misoprostol