Vaginal versus sublingual misoprostol for second-trimester pregnancy termination and effect on Doppler measurements

Abstract Objective To compare the efficacy of vaginal versus sublingual misoprostol for second-trimester pregnancy termination, and to evaluate the effect on the blood flow of the uterine and umbilical arteries. Methods Forty-nine patients were randomized to receive either 200 μg of vaginal misopros...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2009-09, Vol.106 (3), p.250-253
Main Authors: Karsidag, A. Yasemin Karageyim, Buyukbayrak, Esra E., Kars, Bulent, Dansuk, Ramazan, Unal, Orhan, Turan, M. Cem
Format: Article
Language:English
Subjects:
Abortifacient Agents, Nonsteroidal - administration & dosage
Abortion, Induced - methods
Administration, Intravaginal
Administration, Sublingual
Biological and medical sciences
Birth control
Blood Flow Velocity - drug effects
Cardiovascular system
Digestive system
Doppler measurement
Female
Gynecology. Andrology. Obstetrics
Humans
Induced abortion. Therapeutic abortion
Investigative techniques, diagnostic techniques (general aspects)
Laser-Doppler Flowmetry
Medical sciences
Misoprostol - administration & dosage
Obstetrics and Gynecology
Pharmacology. Drug treatments
Pregnancy
Pregnancy Trimester, Second
Regional Blood Flow - drug effects
Second-trimester termination
Sublingual misoprostol
Treatment Outcome
Ultrasonic investigative techniques
Ultrasonography
Umbilical Arteries - diagnostic imaging
Umbilical Arteries - drug effects
Uterus - blood supply
Vaginal misoprostol
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Summary:Abstract Objective To compare the efficacy of vaginal versus sublingual misoprostol for second-trimester pregnancy termination, and to evaluate the effect on the blood flow of the uterine and umbilical arteries. Methods Forty-nine patients were randomized to receive either 200 μg of vaginal misoprostol every 6 hours or 200 μg of misoprostol sublingually every 6 hours. Doppler velocimetry studies were assessed immediately before and 60 minutes after the administration of the first dose. Standard descriptive calculations, Mann–Whitney U, Wilcoxon, and χ2 tests were performed. Results The mean interval between induction and onset of active labor, induction and delivery, and the duration of oxytocin administration were significantly shorter in the sublingual misoprostol group. Both routes of administration increased the Doppler indices for the uterine arteries; however, misoprostol via the sublingual route did not affect the umbilical arteries. Conclusion Sublingual administration of misoprostol for second-trimester medical abortion results in a higher success rate and does not affect umbilical blood flow.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2009.04.001