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A randomized controlled trial comparing powdery sublingual misoprostol and sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy

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Abstract

Objectives

To compare complete abortion rate, duration of abortion, and side effects between 600 μg powdery sublingual misoprostol and 600 μg sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy.

Materials and methods

Fifty-four pregnant women up to 13 weeks of gestation diagnosed with embryonic death or anembryonic pregnancy were randomized to receive 600 μg powdery sublingual misoprostol or 600 μg sublingual misoprostol tablet. Complete abortion was evaluated by transvaginal ultrasound at 48 h.

Results

Twenty-six patients received 600 μg powdery sublingual misoprostol and 28 patients received 600 μg sublingual misoprostol tablet. Complete abortion rate was 34.6% in powdery sublingual misoprostol group and 32.1% in sublingual misoprostol tablet group (P = 0.847). Duration of abortion in powdery sublingual misoprostol group and sublingual misoprostol tablet group was similar (34.7 ± 18.8 vs. 36.9 ± 17.8 h, respectively, P = 0.656). There was no significant difference in the side effects between both groups.

Conclusions

Single dose of 600 μg of powdery sublingual misoprostol does not improve its efficacy for management of embryonic death or anembryonic pregnancy when compared to sublingual misoprostol tablet.

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References

  1. Anonymous (1996) RCR/RCOG Working Party. Early pregnancy assessment. RCOG Press, London

  2. Ayudhaya OP, Herabutya Y, Chanrachakul B, Ayuthaya NI, O-Prasertsawat P (2006) A comparison of the efficacy of sublingual and oral misoprostol 400 microgram in the management of early pregnancy failure: a randomized controlled trial. J Med Assoc Thail 89(Suppl 4):S5–S10

    Google Scholar 

  3. Bagratee JS, Khullar V, Regan L, Moodley J, Kagoro H (2004) A randomized controlled trial comparing medical and expectant management of first trimester miscarriage. Hum Reprod 19:266–271. doi:10.1093/humrep/deh049

    Article  PubMed  CAS  Google Scholar 

  4. Chung TK, Cheung LP, Sahota DS, Haines CJ, Chang AM (1998) Evaluation of the accuracy of transvaginal sonography for the assessment of retained products of conception after spontaneous abortion. Gynecol Obstet Invest 45:190–193. doi:10.1159/000009954

    Article  PubMed  CAS  Google Scholar 

  5. Chung TK, Cheung LP, Sahota DS, Haines CJ, Chang AM (1998) Spontaneous abortion: short-term complications following either conservative or surgical management. Aust N Z J Obstet Gynaecol 38:61–64. doi:10.1111/j.1479-828X.1998.tb02960.x

    Article  PubMed  CAS  Google Scholar 

  6. Fiala C, Gemzell-Danielsson K, Tang OS, von Hertzen H (2007) Cervical priming with misoprostol prior to transcervical procedures. Int J Gynaecol Obstet 99(Suppl 2):S168–S171. doi:10.1016/j.ijgo.2007.09.005

    Article  PubMed  CAS  Google Scholar 

  7. Graziosi GC, Mol BW, Reuwer PJ, Drogtrop A, Bruinse HW (2004) Misoprostol versus curettage in women with early pregnancy failure after initial expectant management: a randomized trial. Hum Reprod 19:1894–1899. doi:10.1093/humrep/deh344

    Article  PubMed  CAS  Google Scholar 

  8. Hamoda H, Ashok PW, Dow J, Flett GM, Templeton A (2003) A pilot study of mifepristone in combination with sublingual or vaginal misoprostol for medical termination of pregnancy up to 63 days gestation. Contraception 68:335–338. doi:10.1016/j.contraception.2003.07.004

    Article  PubMed  CAS  Google Scholar 

  9. Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G (2006) Expectant care versus surgical treatment for miscarriage. Cochrane Database Syst Rev CD003518

  10. Ngai SW, Tang OS, Chan YM, Ho PC (2000) Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability. Hum Reprod 15:1159–1162. doi:10.1093/humrep/15.5.1159

    Article  PubMed  CAS  Google Scholar 

  11. Phupong V, Taneepanichskul S, Kriengsinyot R, Sriyirojana N, Blanchard K, Winikoff B (2004) Comparative study between single dose 600 microgram and repeated dose of oral misoprostol for treatment of incomplete abortion. Contraception 70:307–311. doi:10.1016/j.contraception.2004.04.002

    Article  PubMed  CAS  Google Scholar 

  12. Tang OS, Ho PC (2006) The pharmacokinetics and different regimens of misoprostol in early first-trimester medical abortion. Contraception 74:26–30. doi:10.1016/j.contraception.2006.03.005

    Article  PubMed  CAS  Google Scholar 

  13. Tang OS, Lau WN, Ng EH, Lee SW, Ho PC (2003) A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages. Hum Reprod 18:176–181. doi:10.1093/humrep/deg013

    Article  PubMed  CAS  Google Scholar 

  14. Tang OS, Miao BY, Lee SW, Ho PC (2002) Pilot study on the use of repeated doses of sublingual misoprostol in termination of pregnancy up to 12 weeks gestation: efficacy and acceptability. Hum Reprod 17:654–658. doi:10.1093/humrep/17.3.654

    Article  PubMed  CAS  Google Scholar 

  15. Tang OS, Ong CY, Tse KY, Ng EH, Lee SW, Ho PC (2006) A randomized trial to compare the use of sublingual misoprostol with or without an additional 1 week course for the management of first trimester silent miscarriage. Hum Reprod 21:189–192. doi:10.1093/humrep/dei303

    Article  PubMed  CAS  Google Scholar 

  16. Tang OS, Schweer H, Seyberth HW, Lee SW, Ho PC (2002) Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod 17:332–336. doi:10.1093/humrep/17.2.332

    Article  PubMed  CAS  Google Scholar 

  17. Zhang J, Gilles JM, Barnhart K, Creinin MD, Westhoff C, Frederick MM (2005) A comparison of medical management with misoprostol and surgical management for early pregnancy failure. N Engl J Med 353:761–769. doi:10.1056/NEJMoa044064

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand

    Chatawan Saichua & Vorapong Phupong

Authors
  1. Chatawan Saichua
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  2. Vorapong Phupong
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Correspondence to Vorapong Phupong.

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Saichua, C., Phupong, V. A randomized controlled trial comparing powdery sublingual misoprostol and sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy. Arch Gynecol Obstet 280, 431–435 (2009). https://doi.org/10.1007/s00404-009-0947-x

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  • DOI: https://doi.org/10.1007/s00404-009-0947-x

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