Comparison of Side Effects — Vaginal Versus Oral Misoprostol in Management of First Trimester Missed Abortion

Abstract

Introduction: The therapeutic potential of misoprostol as an abortifacient has clearly been demonstrated in a randomized study. Misoprostol is active and safe both by oral and vaginal routes but the latter has been found to be better in many trials. The aim of the objective is to compare the efficacy and safety of vaginal misoprostol to oral misoprostol for the treatment of first trimester missed abortion. Methods & Materials: The study was conducted in the Gynaecology and Obstetrics Department of Shaheed Ziaur Rahman Medical College Hospital (SZMCH) in Bogra over a period of six months, from May 2015 to October 2015. The participants included women diagnosed with miscarriage, based on both their medical history and physical examinations, and referred from the outpatient department for admission. Result:  Most respondents in both groups were aged 20-25. Among 118 respondents, 9.3% had a previous miscarriage, while 89.8% of Group A and 91.5% of Group B had no history of abortion. Around 42.4% of Group A and 37.3% of Group B were primigravidae. Group B had twice as many second gravidae as Group A. The mean gravidity was 1.81 (SD 1.004) for Group A and 1.78 (SD 1.018) for Group B, with an average gestation period of 10.9 weeks for both. Group B had 76.3% complete expulsion, while Group A had 37.3%. Incomplete and no expulsion rates were higher in Group A. Conclusion: This study concludes that, per vaginal administration of Misoprostol in posterior fornix is more effective than Oral Misoprostol. The former has faster onset of action and better efficacy. Per vaginal Misoprostol have fewer side effects.