Vaginal Misoprostol only Versus Vaginal Misoprostol Preceded by Preinduction Cervical Ripening by Vaginal Misoprostol in Second Trimester Abortion

The present study has been undertaken to study the efficacy, safety, side effects of misoprostol in termination of 2^nd trimester pregnency.

Protocol-1, 48 patients recruited to this protocol were given 200 μgm misoprostol inserted into posterior fornix of vagina every three hourly up to a maximum of five doses or until patients aborted, whichever was earlier. In Protocol-2, 40 patients recruited to this protocol received 200 μgm misoprostol into posterior vaginal fornix for cervical priming. This priming then was followed 6 hours later by induction. Induction was done with 200 μgm of misoprostol inserted into posterior vaginal fornix every 3 hourly for maximum of 5 doses or until patient aborted, whichever was earlier.

Mean dose required to achieve complete abortion in protocol-1 was 650 ± 157 μgm and in protocol-2 was 440 ± 244 μgm. This difference was statistically significant. I-A interval maximum number of patients 36 (74.88%) in protocol-1 and 36 (90%) in protocol-2 aborted within 12 hours with placenta. Mean time required to achieve complete abortion in protocol-1 was 9 ± 5.25 hours and 7.2 ± 3.64 hours in protocol-2.

The result showed that dose of misoprostol and I-A interval decrease when preinduction cervical priming is done by vaginal misoprostol.