Vaginal misoprostol for early second-trimester abortion

Abstract

Objectives To demonstrate the effectiveness and safety of misoprostol without the need of postexpulsion systematic curettage in early second-trimester abortions, i.e. at 13–15 weeks' gestation.

Methods A group of 151 women, with gestations from 85 to 105 days, received 800 μg of vaginal misoprostol every 24 h for a maximum of three doses, without having postexpulsion systematic preventive curettage performed. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side-effects, mean expulsion time and mean time of vaginal bleeding.

Results Complete abortion occurred in 121/151 subjects (80%; 95% confidence interval, 73–87%).The decrease in hemoglobin was statistically significant (p = 0.0001), but without clinical relevance (11.8 mg/dl (SD.0.9) before treatment and 11.4 mg/dl (SD, 1.0) afterwards). No statistically significant differences were found between the success rate and any of the women's characteristics. Vaginal bleeding lasted 6 ± 3 days, spotting 6 ± 3 days, and total bleeding 12 ± 5 days (median, 11 days; range, 1–29 days).

Conclusions The acceptable expulsion time in 80% of the cases, the fact that postabortion systematic curettage was not needed, the clinically insignificant hemoglobin loss and the abortion rate obtained, show that misoprostol by vaginal administration may be an alternative for interrupting gestation in the early second trimester of pregnancy.

Key Words:

• Misoprostol
• Pregnancy termination