Rehana Kamal, Farhat Parveeen, Syeda Batool Mazhar.
Role of Misoprostol in vaginal versus double oro—vaginal route for termination of Pregnancy in mid trimester Pregnancy.
Ann Pak Inst Med Sci Jan ;1(4):196-200.

Objectives: To compare effectiveness of use of Misoprostol in vaginal versus double orovaginal route for termination of mid trimester pregnancy. Study Design: Single centre, quasi-experimental study. Setting: Department of Gynaecology, Unit II, MCH Center PIMS Islamabad Duration: A period of 8 months & 20 days i.e. from 11th October 2004 to 30th June 2005. Methods: All Pregnant women with gestational age between 13 to 28 weeks undergoing induced abortion for maternal or fetal indications were included. Those with previous classical caesarian section, history of myomectomy or having known contraindications to prostaglandins were excluded from the study. In vaginal group, 200-ug Misoprostol was placed in posterior fornix at 6 hourly intervals for a maximum of 8 tablets while in orovaginal group 800-ug was placed in posterior fornix, and oral misoprostol started after the interval of 6 hours, in doses of 200-ug every 3 hours for a maximum of 8 tablets. Primary out come measure was the induction to delivery interval. Secondary outcome measures included, total dose of misoprostol required for delivery, hospital stay and the side effects of the medication. Results: A total of 60 women were assigned to the two groups (30 each). Both groups were comparable with respect to maternal age, parity and gestational age. Mean induction to delivery time of both the groups was same with no statistical significance (11.96 +/- 6.81 Vs 11.17 +/- 7.06, P = 0.665). The overall abortion rate in this study was high, with more than 96% of women delivered with in 48 hours. Significantly increased number of doses were required in oral group of protocol when compared to vaginal group (P = 0.000). Length of hospital stay was same for the both groups (P = 0.387).There was no significant difference between the side effects of the drug in the two groups. Conclusion: Oro-vaginal misoprostol is as effective as vaginal misoprostol and provides a non surgical alternative for mid-trimester pregnancy termination and has no additional side effects.

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