Sage Journals: Discover world-class research

Abstract

Extra-amniotic prostaglandin F₂α (PG F₂α) is probably the most widely used medical method for mid-trimester termination of pregnancy. The method is highly effective but is financially costly, particularly for poor countries faced with restricted health budgets.

The aim of this study was to establish whether misoprostol administered vaginally is as effective as PG F₂α. Sixty-one patients were prospectively randomized to receive either misoprostol (n=30) vaginally, or PG F₂α (n=31) extra-amniotically. The overall success rate was 83.6%. The success rates in the misoprostol and PG F₂α groups were 83.3% and 83.8% respectively. There was no statistical difference in the groups in relation to side effects.

In this carefully selected group of patients, misoprostol was as safe and effective as PG F₂α in mid-trimester termination of pregnancy. In these days of financial constraints, misoprostol is the preferred method for mid-trimester termination of pregnancy.

Get full access to this article

View all access options for this article.

References

Bugalho

Bique

. The effectiveness of intravaginal misoprostol in inducing abortion after eleven weeks. Stud Fam Plan 1993;24:319–23.

Barbosa

Arilha

. The Brazillian experience with misoprostol. Stud Fam Plan 1993;24:236–40.

Templeton

. Misoprostol for all. Br J Obstet Gynaecol 1998; 105:937–9.

Zieman

Fong Susan

Benowitz

The absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol 1997;90:88–92.

Fletcher

McCaw-Binns . Rupture of the uterus with misoprostol (prostaglandins E₁) used for induction of labour. J Obstet Gynecol 1998;18:184–5.

Phillips

Berry

Mathers

Uterine rupture during second trimester termination of pregnancy using mifepristone and a prostaglandin. Euro J Obstet Gynaecol Reprod Biol 1996;65:175–6.

Pak-Chung

Suk-Wai

Liu

Ka-Lai

. Vaginal misoprostol compared with oral misoprostol in termination of second trimester pregnancy. Obstet Gynecol 1997;90:735–8.

Krolikowski

Jonowski

Larsen

. Termination of pregnancy using extra amniotic prostaglandin F₂α. Experience in a peripheral hospital. Cent Afr J 1994;40:204–6.

Toppozada

Shaala

Anwar

Termination of pregnancy with fetal death in the second and third trimester — the double balloon verses extra amniotic prostaglandin. Int J Obstet Gynecol 1994;45:269–73.

10.

MacLennan

Chan

Eckert

. The safety of vaginal prostaglandin PGF₂α for the stimulation of labour. Aust/New Z J Obstet Gynaecol 1994;34:154–8.

11.

Lipitz

Grisaru

Libshiz

Intra amniotic prostaglandin F₂α for pregnancy termination in the second and early third trimesters of pregnancy. J Rep Med 1997;42:235–8.

12.

Chandra

Gupta

Dhawan

. Prostaglandin F₂α levels in normal saline induced mid trimester abortions. Contraception 1991;44:99–106.

13.

Lurie

Katz

Vaclav

. Midtrimester induction of abortion comparison of extraovular prostaglandin E₂ and intra amniotic prostaglandin F₂ for therapeutic abortion. Am J Obstet Gynecol 1972;113:340–4.

14.

Bugalho

Bique

. Uterine evacuation by vaginal misoprostol after second trimester pregnancy interruption. Acta Obstet Gynaecol Scand 1996;75:270–3.

15.

Jain

Mishell

Jr . A comparison of intravaginal misoprostol with prostaglandin E₂ for termination of second trimester pregnancy. Engl J Med 1994;331:290–3.

16.

Del Valle

Ramos

Jordon

Use of misoprostol (prostaglandin E₁ methyl analogue) to expedite delivery in severe pre-eclampsia remote from term. J Mat Fet Med 1996;5:39–40.

17.

World Health Organization Task Force on the use of prostaglandins for the regulation of fertility: prostaglandins and abortion. Comparison of single intra-amniotic injection of 15 methyl prostaglandin F₂α for termination of second trimester pregnancy. An international multicenter study. Am J Obstet Gynecol 1977;129:601–6.

18.

Norman

. Uterine rupture during therapeutic abortion in the second trimester using Mifepristone and prostaglandin. Br J Obstet Gynaecol 1995;102:332–3.

19.

Suraggo

Robins

. Midtrimester pregnancy termination by intravaginal prostaglandin E₂ . Contraception 1982;26:285–94.

20.

RCOG. The care of women requesting induced abortion. In: Evidence Based Guidelines. London: Royal College of Obstetricians and Gynaecologists, 1999;7:1–10.

21.

Ghorab

MNM

El Helw

. Second trimester termination of pregnancy by extra-amniotic prostaglandin F₂α or endocervical misoprostol: a comparative study. Acta Obstet Gynaecol Scand 1998;77:429–32.

22.

Jain

Kuo

Mishell

. A comparison of two doses of intravaginal misoprostol for second trimester pregnancy termination. Obstet Gynecol 1999;93:571–5.

The Use of Misoprostol for Mid-Trimester Therapeutic Termination of Pregnancy

Abstract

Get full access to this article

References