A randomized trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion at 13-20 weeks gestation

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

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

BACKGROUND: Several studies have now reported the successful use of the sublingual administration of misoprostol for medical abortion in the first trimester. The objective of this study was to assess the acceptability to women, the efficacy of the regimen, as well as the acceptability to staff of sublingual versus vaginal administration of misoprostol following mifepristone for medical abortion at 13-20 weeks gestation. METHODS: Women were randomized by opening consecutive sealed envelopes generated using random number tables. Mifepristone (200 mg) was followed 36-48 h later by sublingual administration of misoprostol 600 mu g or vaginal misoprostol 800 mu g. This was followed by 3 hourly doses of misoprostol 400 mu g administered sublingually or vaginally. RESULTS: A total of 76 women were randomized. Of women in the sublingual group, 24 (66.7%) expressed satisfaction with the route of misoprostol administration compared with 25 (62.5%) in the vaginal group. A higher proportion in the sublingual group used intramuscular opiates. There was no significant difference in the surgical evacuation rate between the sublingual (three out of 36 women, 8.3%) and vaginal groups (one out of 40, 2.5%), (P=0.26) and acceptability to staff was the same for both methods. CONCLUSIONS: Sublingual administration of misoprostol following mifepristone is an acceptable and effective alternative to vaginal administration for medical abortion at 13-20 weeks gestation. However, women should be advised about the greater likelihood of requiring stronger analgesia.

Original languageEnglish
Pages (from-to)2348-2354
Number of pages6
JournalHuman Reproduction
Volume20
Issue number8
DOIs
Publication statusPublished - 2005

Keywords

  • medical abortion
  • midtrimester
  • mifepristone
  • misoprostol
  • sublingual
  • 2ND TRIMESTER
  • 2ND-TRIMESTER ABORTION
  • DIFFERENT ROUTES
  • PREGNANCY
  • TERMINATION
  • INDUCTION
  • GEMEPROST

Cite this

@article{b4f9ea19f7d44954b6126cfe304d78a6,
title = "A randomized trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion at 13-20 weeks gestation",
abstract = "BACKGROUND: Several studies have now reported the successful use of the sublingual administration of misoprostol for medical abortion in the first trimester. The objective of this study was to assess the acceptability to women, the efficacy of the regimen, as well as the acceptability to staff of sublingual versus vaginal administration of misoprostol following mifepristone for medical abortion at 13-20 weeks gestation. METHODS: Women were randomized by opening consecutive sealed envelopes generated using random number tables. Mifepristone (200 mg) was followed 36-48 h later by sublingual administration of misoprostol 600 mu g or vaginal misoprostol 800 mu g. This was followed by 3 hourly doses of misoprostol 400 mu g administered sublingually or vaginally. RESULTS: A total of 76 women were randomized. Of women in the sublingual group, 24 (66.7{\%}) expressed satisfaction with the route of misoprostol administration compared with 25 (62.5{\%}) in the vaginal group. A higher proportion in the sublingual group used intramuscular opiates. There was no significant difference in the surgical evacuation rate between the sublingual (three out of 36 women, 8.3{\%}) and vaginal groups (one out of 40, 2.5{\%}), (P=0.26) and acceptability to staff was the same for both methods. CONCLUSIONS: Sublingual administration of misoprostol following mifepristone is an acceptable and effective alternative to vaginal administration for medical abortion at 13-20 weeks gestation. However, women should be advised about the greater likelihood of requiring stronger analgesia.",
keywords = "medical abortion, midtrimester, mifepristone, misoprostol, sublingual, 2ND TRIMESTER, 2ND-TRIMESTER ABORTION, DIFFERENT ROUTES, PREGNANCY, TERMINATION, INDUCTION, GEMEPROST",
author = "Haitham Hamoda and Ashok, {Premila Wencesiaus} and Flett, {G. M. M.} and Templeton, {Alexander Allan}",
year = "2005",
doi = "10.1093/humrep/dei037",
language = "English",
volume = "20",
pages = "2348--2354",
journal = "Human Reproduction",
issn = "0268-1161",
publisher = "OXFORD UNIV PRESS",
number = "8",

}

TY - JOUR

T1 - A randomized trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion at 13-20 weeks gestation

AU - Hamoda, Haitham

AU - Ashok, Premila Wencesiaus

AU - Flett, G. M. M.

AU - Templeton, Alexander Allan

PY - 2005

Y1 - 2005

N2 - BACKGROUND: Several studies have now reported the successful use of the sublingual administration of misoprostol for medical abortion in the first trimester. The objective of this study was to assess the acceptability to women, the efficacy of the regimen, as well as the acceptability to staff of sublingual versus vaginal administration of misoprostol following mifepristone for medical abortion at 13-20 weeks gestation. METHODS: Women were randomized by opening consecutive sealed envelopes generated using random number tables. Mifepristone (200 mg) was followed 36-48 h later by sublingual administration of misoprostol 600 mu g or vaginal misoprostol 800 mu g. This was followed by 3 hourly doses of misoprostol 400 mu g administered sublingually or vaginally. RESULTS: A total of 76 women were randomized. Of women in the sublingual group, 24 (66.7%) expressed satisfaction with the route of misoprostol administration compared with 25 (62.5%) in the vaginal group. A higher proportion in the sublingual group used intramuscular opiates. There was no significant difference in the surgical evacuation rate between the sublingual (three out of 36 women, 8.3%) and vaginal groups (one out of 40, 2.5%), (P=0.26) and acceptability to staff was the same for both methods. CONCLUSIONS: Sublingual administration of misoprostol following mifepristone is an acceptable and effective alternative to vaginal administration for medical abortion at 13-20 weeks gestation. However, women should be advised about the greater likelihood of requiring stronger analgesia.

AB - BACKGROUND: Several studies have now reported the successful use of the sublingual administration of misoprostol for medical abortion in the first trimester. The objective of this study was to assess the acceptability to women, the efficacy of the regimen, as well as the acceptability to staff of sublingual versus vaginal administration of misoprostol following mifepristone for medical abortion at 13-20 weeks gestation. METHODS: Women were randomized by opening consecutive sealed envelopes generated using random number tables. Mifepristone (200 mg) was followed 36-48 h later by sublingual administration of misoprostol 600 mu g or vaginal misoprostol 800 mu g. This was followed by 3 hourly doses of misoprostol 400 mu g administered sublingually or vaginally. RESULTS: A total of 76 women were randomized. Of women in the sublingual group, 24 (66.7%) expressed satisfaction with the route of misoprostol administration compared with 25 (62.5%) in the vaginal group. A higher proportion in the sublingual group used intramuscular opiates. There was no significant difference in the surgical evacuation rate between the sublingual (three out of 36 women, 8.3%) and vaginal groups (one out of 40, 2.5%), (P=0.26) and acceptability to staff was the same for both methods. CONCLUSIONS: Sublingual administration of misoprostol following mifepristone is an acceptable and effective alternative to vaginal administration for medical abortion at 13-20 weeks gestation. However, women should be advised about the greater likelihood of requiring stronger analgesia.

KW - medical abortion

KW - midtrimester

KW - mifepristone

KW - misoprostol

KW - sublingual

KW - 2ND TRIMESTER

KW - 2ND-TRIMESTER ABORTION

KW - DIFFERENT ROUTES

KW - PREGNANCY

KW - TERMINATION

KW - INDUCTION

KW - GEMEPROST

U2 - 10.1093/humrep/dei037

DO - 10.1093/humrep/dei037

M3 - Article

VL - 20

SP - 2348

EP - 2354

JO - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

IS - 8

ER -