Comparative study of oral and vaginal misoprostol for cervical priming prior to first trimester suction evacuation

Background: To compare the effectiveness of vaginal with oral misoprostol as a cervical ripening agent prior to first trimester suction evacuation and to compare side effects. Methods: Hundred and fifty one women opting for medical termination of pregnancy in first trimester were randomized to receive 400?g oral and vaginal misoprostol. Suction evacuation was carried out 3 to 4 hours after misoprostol. Results were analyzed. Results: Products of conception were noted in 15.8% of patients in vaginal group compared to only 5.3% of patients in the oral group. 89.4% of patients in vaginal group had dilatation of ? 7 Hegar’s compared to 58.6% in oral group. Additional dilatation was required in 69.3% in oral group compared to 38.1% patients in vaginal group; all these results being statistically significant. Adverse effects were noted in 50.7% of patients in oral group and 25% of patients in vaginal group. Conclusion: Comparing the oral and vaginal route of 400?g of misoprostol 3 to 4 hours before suction evacuation, it was observed that vaginal route is associated with better results and fewer side effects. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000): 573-576]