TY - JOUR
T1 - A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination
AU - Bebbington, Michael W.
AU - Kent, Nancy
AU - Lim, Ken
AU - Gagnon, Alain
AU - Delisle, Marie France
AU - Tessier, Francine
AU - Wilson, R. Douglas
PY - 2002/10
Y1 - 2002/10
N2 - OBJECTIVE: Our purpose was to compare the efficacy of oral misoprostol with that of vaginal misoprostol for midtrimester termination of pregnancy. STUDY DESIGN: Women seen for midtrimester pregnancy termination were randomly assigned to receive either misoprostol orally in a dose of 200 μg every hour for 3 hours followed by 400 μg every 4 hours or vaginally in a dose of 400 μg every 4 hours. The protocol was followed for 24 hours, after which time further management was at the discretion of the attending physician. The primary outcome measure was the induction-to-delivery interval. Sample size was calculated a priori. Statistical analysis was performed with the t test for continuous variables and the X2 test for categorical variables, P < .05 was considered significant. RESULTS: One hundred fourteen women were randomized, with 49 receiving vaginal misoprostol and 65 receiving oral misoprostol. The two groups were comparable with respect to maternal age, parity, indication for pregnancy termination, gestational age, and maternal weight. The mean induction-to-delivery interval was significantly shorter for the vaginal group (19.6 ± 17.5 hours vs 34.5 ± 28.2 hours, P < .01). Length of stay was also shorter in the vaginal group (32.3 ± 17.3 hours vs 50.9 ± 27.9 hours, P < .01). Significantly more patients in the vaginal group were delivered within 24 hours (85.1% vs 39.5%, P < 0.1), and more patients in the oral group required changes in the method of induction when they were undelivered after 24 hours (38.2% vs 7%, P < .01). The only complication was an increase in febrile morbidity in the vaginal group (25% vs 6.7%, P = .046). This did not result in an increased use of antibiotics, and all the fevers resolved post partum without further complications. CONCLUSIONS: Vaginal administration of misoprostol resulted in a shorter induction-to-delivery interval. The shorter length of stay should result in improved patient care.
AB - OBJECTIVE: Our purpose was to compare the efficacy of oral misoprostol with that of vaginal misoprostol for midtrimester termination of pregnancy. STUDY DESIGN: Women seen for midtrimester pregnancy termination were randomly assigned to receive either misoprostol orally in a dose of 200 μg every hour for 3 hours followed by 400 μg every 4 hours or vaginally in a dose of 400 μg every 4 hours. The protocol was followed for 24 hours, after which time further management was at the discretion of the attending physician. The primary outcome measure was the induction-to-delivery interval. Sample size was calculated a priori. Statistical analysis was performed with the t test for continuous variables and the X2 test for categorical variables, P < .05 was considered significant. RESULTS: One hundred fourteen women were randomized, with 49 receiving vaginal misoprostol and 65 receiving oral misoprostol. The two groups were comparable with respect to maternal age, parity, indication for pregnancy termination, gestational age, and maternal weight. The mean induction-to-delivery interval was significantly shorter for the vaginal group (19.6 ± 17.5 hours vs 34.5 ± 28.2 hours, P < .01). Length of stay was also shorter in the vaginal group (32.3 ± 17.3 hours vs 50.9 ± 27.9 hours, P < .01). Significantly more patients in the vaginal group were delivered within 24 hours (85.1% vs 39.5%, P < 0.1), and more patients in the oral group required changes in the method of induction when they were undelivered after 24 hours (38.2% vs 7%, P < .01). The only complication was an increase in febrile morbidity in the vaginal group (25% vs 6.7%, P = .046). This did not result in an increased use of antibiotics, and all the fevers resolved post partum without further complications. CONCLUSIONS: Vaginal administration of misoprostol resulted in a shorter induction-to-delivery interval. The shorter length of stay should result in improved patient care.
KW - Midtrimester pregnancy termination
KW - Misoprostol
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=0036795708&partnerID=8YFLogxK
U2 - 10.1067/mob.2002.127461
DO - 10.1067/mob.2002.127461
M3 - Article
C2 - 12388963
AN - SCOPUS:0036795708
SN - 0002-9378
VL - 187
SP - 853
EP - 857
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4
ER -