COMPARATIVE STUDY OF ORAL AND VAGINAL MISOPROSTOL FOR MEDICAL EVACUATION IN INCOMPLETE MISCARRIAGE

Objectives- To compare the effectiveness, side effects and patient acceptability of oral vs vaginal route of administration of misoprostol for medical evacuation in first trimester incomplete abortion. Methods- This prospective randomized comparative study was conducted on 200 women with spontaneous incomplete first trimester pregnancy loss. They were distributed in two groups receiving 800 micrograms of misoprostol; vaginally in the first group and orally in the second group. Amount of bleeding, duration of time for complete evacuation and side effects were noted and data statistically analysed using chi-square test and student t-test. Results- No statistically significant difference was observed in the percentage of women who had complete evacuation following the use of misoprostol by the two routes.The duration from administration of drug to complete evacuation was 6.65+/- 1.05 hours in vaginal route and 6.68+/- 1.19 hours in oral route; this difference is not statistically significant. Only 6% women in vaginal route reported diarrhoea as compared to 59% in oral route and this difference is significant. Other side effects were rare and same in both groups. Conclusion- vaginally and orally administered misoprostol are equally efficacious in first trimester incomplete abortion, but vaginal route has fewer side effects and better patient acceptability.