A Comparison between Dry and Moistened Intravaginal Misoprostol for Termination of Second Trimester Pregnancy: A Randomized Comparative Trial

Background: This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vaginally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death. Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misoprostol, a synthetic analoge of prostaglandin El alprostadil, (200 μg intravaginally every 4 hours) either in its dry form (group A) or moistened with 1 ml of saline (group B). The study population included 136 pregnant women between 14 and 24 weeks gestation who were seeking for termination of pregnancy because of intrauterine fetal death. Setting: Woman s Health Center, Assiut University. Results: All patients in both groups aborted within 48 hours ( 100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p 0.01) patients in group B had significantly short median induction-abortion interval (p 0.01), less total numbers of doses (p 0.05), less retained placenta (p 0.05), more abortion within 24 hours (p 0.01), more abortion with the I st dose (p 0.01), but had more need for analgesia and more incidence of side effects (p 0.01). Conclusions: The intravaginal administration of 200 μg of misoprostol tablet moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablet. However, it was associated with more side effects which were well tolerated.