A pilot randomised study to compare sub-lingual and vaginal routes of low-dose misoprostol following two sequential doses of mifepristone for second-trimester medical abortion

A randomized study to compare the induction abortion interval (IAI) using two different routes of Low-dose misoprostol administration Sublingual (S/L) and vaginal, after priming with two sequential doses of mifepristone for second-trimester medical abortion. After randomization in two groups, participants received two doses of mifepristone (200 mg) 24 h apart. On day 3, 200mcg of misoprostol was given by S/L route to group 1 and by vaginal route to group 2, (400mcg among women with gestation ≤16 weeks) and every 6 hours for a maximum of 3 doses. The mean IAI (13.71±8.55 h and 13.22±8.22 h; p=0.768), mean number of misoprostol doses (2.08±1.08 and 2.54±1.12, p=0.05) and mean misoprostol dose (453.9±224.93 and 492.31±208.23 mcg, p=0.409) was similar. The complete abortion rate after 24 h (77.5% vs 87.5%, p=0.23), after 48 h (95% vs 97.5%, p=1.00) and minimal untoward effects seen were all similar in the two groups. Both SL and vaginal routes of misoprostol, after two doses of mifepristone were equally effective. The mean cumulative doses of misoprostol were similar, and a complete abortion rate of > 95% at 48 h was achieved with either route.>95.