Vaginal Misoprostol vs. Concentrated Oxytocin Plus Low-Dose Prostaglandin E₂ for Second Trimester Pregnancy Termination

Abstract

Objective: To examine the efficacy of vaginal misoprostol for mid-trimester pregnancy termination.

Results: Interim analysis of the first 30 (15-misoprostol, 15-concentrated oxytocin) women demonstrated that the 2 groups were similar with regard to indication for delivery, gestational age, and demographic characteristics. Misoprostol was associated with a lower success rate (67 vs. 87%, P =. 2), a longer induction-delivery interval (22 h vs. 18 h, P =. 09), a higher rate of retained placenta requiring curettage (27 vs. 13%, P =. 65), and a higher live birth rate (50 vs. 0%, P =. 006).

Conclusions: Compared to a regimen of concentrated oxytocin plus low-dose prostaglandin E₂, misoprostol administered as vaginal tablets in a dose of 200 μg q 12 h is not satisfactory for mid-trimester pregnancy termination in an unselected population.

Methods: This randomized trial compared misoprostol, 200 μg per vaginum q 12 h to a protocol of concentrated oxytocin plus low-dose vaginal prostaglandin E₂ suppositories (10 mg q 6 h). Success was defined as an induction-to-delivery interval ≤24 h.

Key Words:

• pregnancy termination
• oxytocin
• misoprostol