Abstract
Aim: To compare the effectiveness of misoprostol as a cervical ripening agent in first trimester miscarriage through different routes of administration before surgical evacuation.
Design: This was a randomized controlled trial
Place of study: Islam Medical College and affiliated hospitals.
Methods: Total 100 patients undergoing surgical evacuation for missed miscarriage between 7-13 weeks of gestation were included in the study. In each group 50 patients were taken. Misoprostol was given through sublingual and vaginal route after dividing the patients into two groups. The women were randomized to either 400 microgram vaginal misoprostol or 400 microgram sublingual misoprostol 3-4 hours prior to surgical evacuation. Main outcome measures studied were preoperative cervical dilatation and side effects of misoprostol
Results: Cervical ripening effect and mean time taken for cervical dilatation were more favorable among sublingual route than vaginal route. Vaginal bleeding was observed more in vaginal route group than in sublingual route. Abdominal cramps headache were most commonly observed side effects in both the group, where as nausea and vomiting were more seen in sublingual route group.
Conclusion: Sublingual administration of misoprostol is better than vaginal administration for cervical ripening before surgical evacuation in patients with missed miscarriage