Randomised controlled study comparing oral and vaginal misoprostol for cervical priming prior to surgical termination of pregnancy

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

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective To compare the effectiveness of oral misoprostol with vaginal misoprostol as a cervical priming agent prior to first trimester vacuum aspiration.

Design Randomised study.

Setting Scottish teaching hospital.

Population Primigravid women at gestations up to 91 days requesting surgical abortion under the 1967 Abortion Act.

Methods Sixty-four women were randomised to receive misoprostol 400 mug orally at home or vaginally in hospital 2-4 hours pre-operatively for cervical priming.

Main outcome measures The main outcome measures were cumulative force required to dilate the cervix to 9 mm, baseline cervical dilatation, intra-operative blood loss and patient and staff acceptability.

Results There was no significant difference in baseline cervical dilatation, peak force required to dilate the cervix at 8 and 9 mm and cumulative force required between the two groups. Operating time and intra-operative blood loss were not significantly different between the two groups. The priming to abortion interval was significantly longer with oral misoprostol when compared with the vaginal group (P < 0.0001). Women receiving oral misoprostol were significantly more likely to experience nausea (OR: 3.9, 95% CI: 1.3 to 11.2), while women receiving vaginal misoprostol were more likely to complain of tiredness (OR: 0.2, 95% CI: 0.1 to 0.7) with no significant differences in other side effects between the two groups. There was no significant difference in patient acceptability in relation to the priming agent between the two groups (P = 0.96). However, majority of the nursing staff (83%) admitting women preferred the oral route of administration.

Conclusion Cervical priming with oral misoprostol at home is effective with high patient and staff acceptability.

Original languageEnglish
Pages (from-to)1057-1061
Number of pages4
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume110
Issue number12
DOIs
Publication statusPublished - 2003

Keywords

  • VACUUM ASPIRATION
  • SUBLINGUAL MISOPROSTOL
  • CURETTAGE ABORTION
  • DILATATION
  • MIFEPRISTONE
  • GEMEPROST
  • GESTATION
  • TRIAL

Cite this

@article{5c2b15163e5e4d358267870ac0d0a4ca,
title = "Randomised controlled study comparing oral and vaginal misoprostol for cervical priming prior to surgical termination of pregnancy",
abstract = "Objective To compare the effectiveness of oral misoprostol with vaginal misoprostol as a cervical priming agent prior to first trimester vacuum aspiration.Design Randomised study.Setting Scottish teaching hospital.Population Primigravid women at gestations up to 91 days requesting surgical abortion under the 1967 Abortion Act.Methods Sixty-four women were randomised to receive misoprostol 400 mug orally at home or vaginally in hospital 2-4 hours pre-operatively for cervical priming.Main outcome measures The main outcome measures were cumulative force required to dilate the cervix to 9 mm, baseline cervical dilatation, intra-operative blood loss and patient and staff acceptability.Results There was no significant difference in baseline cervical dilatation, peak force required to dilate the cervix at 8 and 9 mm and cumulative force required between the two groups. Operating time and intra-operative blood loss were not significantly different between the two groups. The priming to abortion interval was significantly longer with oral misoprostol when compared with the vaginal group (P < 0.0001). Women receiving oral misoprostol were significantly more likely to experience nausea (OR: 3.9, 95{\%} CI: 1.3 to 11.2), while women receiving vaginal misoprostol were more likely to complain of tiredness (OR: 0.2, 95{\%} CI: 0.1 to 0.7) with no significant differences in other side effects between the two groups. There was no significant difference in patient acceptability in relation to the priming agent between the two groups (P = 0.96). However, majority of the nursing staff (83{\%}) admitting women preferred the oral route of administration.Conclusion Cervical priming with oral misoprostol at home is effective with high patient and staff acceptability.",
keywords = "VACUUM ASPIRATION, SUBLINGUAL MISOPROSTOL, CURETTAGE ABORTION, DILATATION, MIFEPRISTONE, GEMEPROST, GESTATION, TRIAL",
author = "Ashok, {Premila Wencesiaus} and Haitham Hamoda and F. Nathani and Flett, {G. M.} and Templeton, {Alexander Allan}",
year = "2003",
doi = "10.1111/j.1471-0528.2003.03115.x",
language = "English",
volume = "110",
pages = "1057--1061",
journal = "BJOG-An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "John Wiley & Sons, Ltd (10.1111)",
number = "12",

}

TY - JOUR

T1 - Randomised controlled study comparing oral and vaginal misoprostol for cervical priming prior to surgical termination of pregnancy

AU - Ashok, Premila Wencesiaus

AU - Hamoda, Haitham

AU - Nathani, F.

AU - Flett, G. M.

AU - Templeton, Alexander Allan

PY - 2003

Y1 - 2003

N2 - Objective To compare the effectiveness of oral misoprostol with vaginal misoprostol as a cervical priming agent prior to first trimester vacuum aspiration.Design Randomised study.Setting Scottish teaching hospital.Population Primigravid women at gestations up to 91 days requesting surgical abortion under the 1967 Abortion Act.Methods Sixty-four women were randomised to receive misoprostol 400 mug orally at home or vaginally in hospital 2-4 hours pre-operatively for cervical priming.Main outcome measures The main outcome measures were cumulative force required to dilate the cervix to 9 mm, baseline cervical dilatation, intra-operative blood loss and patient and staff acceptability.Results There was no significant difference in baseline cervical dilatation, peak force required to dilate the cervix at 8 and 9 mm and cumulative force required between the two groups. Operating time and intra-operative blood loss were not significantly different between the two groups. The priming to abortion interval was significantly longer with oral misoprostol when compared with the vaginal group (P < 0.0001). Women receiving oral misoprostol were significantly more likely to experience nausea (OR: 3.9, 95% CI: 1.3 to 11.2), while women receiving vaginal misoprostol were more likely to complain of tiredness (OR: 0.2, 95% CI: 0.1 to 0.7) with no significant differences in other side effects between the two groups. There was no significant difference in patient acceptability in relation to the priming agent between the two groups (P = 0.96). However, majority of the nursing staff (83%) admitting women preferred the oral route of administration.Conclusion Cervical priming with oral misoprostol at home is effective with high patient and staff acceptability.

AB - Objective To compare the effectiveness of oral misoprostol with vaginal misoprostol as a cervical priming agent prior to first trimester vacuum aspiration.Design Randomised study.Setting Scottish teaching hospital.Population Primigravid women at gestations up to 91 days requesting surgical abortion under the 1967 Abortion Act.Methods Sixty-four women were randomised to receive misoprostol 400 mug orally at home or vaginally in hospital 2-4 hours pre-operatively for cervical priming.Main outcome measures The main outcome measures were cumulative force required to dilate the cervix to 9 mm, baseline cervical dilatation, intra-operative blood loss and patient and staff acceptability.Results There was no significant difference in baseline cervical dilatation, peak force required to dilate the cervix at 8 and 9 mm and cumulative force required between the two groups. Operating time and intra-operative blood loss were not significantly different between the two groups. The priming to abortion interval was significantly longer with oral misoprostol when compared with the vaginal group (P < 0.0001). Women receiving oral misoprostol were significantly more likely to experience nausea (OR: 3.9, 95% CI: 1.3 to 11.2), while women receiving vaginal misoprostol were more likely to complain of tiredness (OR: 0.2, 95% CI: 0.1 to 0.7) with no significant differences in other side effects between the two groups. There was no significant difference in patient acceptability in relation to the priming agent between the two groups (P = 0.96). However, majority of the nursing staff (83%) admitting women preferred the oral route of administration.Conclusion Cervical priming with oral misoprostol at home is effective with high patient and staff acceptability.

KW - VACUUM ASPIRATION

KW - SUBLINGUAL MISOPROSTOL

KW - CURETTAGE ABORTION

KW - DILATATION

KW - MIFEPRISTONE

KW - GEMEPROST

KW - GESTATION

KW - TRIAL

U2 - 10.1111/j.1471-0528.2003.03115.x

DO - 10.1111/j.1471-0528.2003.03115.x

M3 - Article

VL - 110

SP - 1057

EP - 1061

JO - BJOG-An International Journal of Obstetrics and Gynaecology

JF - BJOG-An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 12

ER -