Combined Sublingual and Vaginal Misoprostol for Second Trimester Pregnancy Termination in Women with Live and Dead Fetuses

Abstract

          A prospective comparative study was performed to compare efficacy and side effects of combined sublingual and vaginal misoprostol for second trimester pregnancy termination between live and dead fetuses. Pregnant women (14-28 weeks of gestation with reasons for pregnancy termination) with dead fetuses (22 cases) and live fetuses (19 cases) were recruited to receive 200 µg sublingual misoprostol followed by 200 µg vaginal misoprostol every 8 hours after an hour of sublingual dose. The successful abortion rates with in 12, 24 and 48 hours were significantly higher in dead fetus group than another group. (63.64%, 100%, 100% and 20.05%, 73.68%, 100%, respectively; p = 0.01). The abortion time was significantly shorter in dead fetus group. No statistic difference in the complete abortion rate. The mean vaginal misoprostol dosage were significantly different (p = 0.001; 290.90 and 547.36 µg, used in dead and live fetus group, respectively). Fever was the only side effect, significantly more occurred in live fetus group. In conclusion, combined sublingual and vaginal misoprostol dose is an effective and safe method for second trimester pregnancy termination. The success rate was higher, the abortion time was shorter and vaginal misoprostol dosage was less in dead fetus group than in live fetus group.