The study aimed to compare the efficacy and safety of two combined misoprostol regimens for second-trimester medical abortion.
This retrospective cohort study examined data on singleton pregnancies that underwent a second-trimester medical abortion in a tertiary care center in northern Greece. In the first study period, the management protocol consisted of 800 μg vaginal misoprostol followed by 400 μg oral misoprostol every three h, for up to five doses. In the second study period, a new protocol was introduced, where the oral route was changed to sublingual, using the same dosage. The two courses were compared in terms of efficacy and safety.
The study comprised 85 women: 43 received the protocol one regimen, while 42 received the two regimens. The groups did not differ in terms of maternal age, gestational age, and parity. Sublingual misoprostol was more effective than oral misoprostol, both in terms of dose needed and induction-to-abortion interval. Due to incomplete abortion, the surgical evacuation was necessary for 11.9% of women in the sublingual group vs. 18.6% in the oral group. Women in the sublingual group reported a higher rate of severe pain and shivering.
When compared with the vaginal-oral regimen, the administration of vaginal-sublingual misoprostol was associated with a shorter induction-to-abortion interval but a higher incidence of severe pain and shivering.
Reference: https://www.tandfonline.com/doi/full/10.1080/13625187.2020.1830966
