A randomized controlled comparison of sublingual and vaginal administration of misoprostol for cervical priming before first-trimester surgical abortion

Haitham Hamoda, Premila Wencesiaus Ashok, Alexander Allan Templeton, G. M. Flett

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    Objective: The purpose of this study was to compare the effectiveness of the sublingual and vaginal administration of misoprostol for cervical priming before surgical termination of pregnancy.
    Study design: In a randomized controlled trial, 74 primigravid women who were undergoing surgical abortion were assigned randomly to receive misoprostol (400 mug) sublingually or vaginally.
    Results: There was no statistically significant difference in the cumulative force that was required to dilate the cervix to 9 mm, for baseline cervical dilatation, for priming to abortion interval, for operating time, or for intraoperative blood loss between the two groups. Women in the sublingual group had more nausea (P=.008), vomiting (P=.01), diarrhea (P=.01), and unpleasant mouth taste (P=.0001) compared with the women in the vaginal group. In the sublingual group, 65% of women were satisfied with the route of misoprostol administration compared with 78% in the vaginal group (P=.11). Most of the staff members (84%) said that they would recommend the sublingual administration of misoprostol (P=.0001).
    Conclusion: The sublingual administration of misoprostol is an effective alternative to vaginal administration for cervical priming before surgical abortion; despite a higher incidence of side effects, there was high patient and staff acceptability. (C) 2004 Elsevier Inc. All rights reserved.

    Original languageEnglish
    Pages (from-to)55-59
    Number of pages4
    JournalAmerican Journal of Obstetrics and Gynecology
    Issue number1
    Publication statusPublished - Jan 2004


    • surgical abortion
    • cervical priming
    • misoprostol
    • sublingual administration
    • vaginal administration
    • vacuum aspiration
    • medical abortion
    • oral Misoprostol
    • pregnancy termination
    • curettage abortion
    • weeks gestation
    • Mifepristone
    • dilatation
    • Gemeprost
    • trial

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