A PROSPECTIVE RANDOMEZED CONTROLLED TRIAL OF TWO REGIMENS OF VAGINAL MISOPROSTOL IN SECOND TRIMESTER TERMINATION OF PREGNANCY

The search continues for a safe effective and cheap method for mid-trimester termination of pregnancy. Misoprostol is a strong contender in this respect. The dose schedule is still not fixed. The objective of this study was to compare the efficacy and adverse effects of two dose regimens of vaginal misoprostol for second trimester termination. Prospective randomized double blind controlled trial was undertaken in 162 women at 14-24 weeks gestation in a teaching hospital. Subjects were randomized to receive either regime A: 400 0g of intra vaginal misoprostol every 6h, or regime B: 200 0g of intravaginal misoprostol every 6h. The main outcome measure was the success rate at 24h, total dose required, induction-abortion interval and adverse effects. Data was analyzed by student’s t-test, Mannwhitney U-test, the chi-squared test or Fisher’s exact test. There was a significant difference in the success rate at 24 and 48hr (regime A: 74% and 97.5%; regime B: 61.7% and 88.9% P=0.016 & 0.029 respectively) and in the mean induction abortion interval (14 Vs 20h, P=0.01) Mean Misoprostol requirement was significantly higher for regime A (731 0g ± 362 0g vs. 5310g ± 3570gm, P=0.001). Use of 400 0g vaginal misoprostol is superior to 200 0g vaginal misoprostol for second trimester abortion.