A study on sublingual versus vaginal misoprostol for cervical priming in i trimester mtp – a randomised trial

Abstract

Objective: To compare the effectiveness and acceptability of sublingual and vaginal misoprostol for cervical priming in I Trimester MTP. Methods: 100 women were divided into two groups of 50 each. Group A patients were given 400µg of sublingual misoprostol 3 hours prior to MVA. In group B, 400 µg of misoprostol was placed in the posterior fornix 3 hours prior to MVA. Primary outcome was degree of dilatation achieved. Secondary outcomes were duration of procedure, intra operative blood loss, side effects and pain score. Results: The mean cervical dilatation in the sublingual group was 9 mm. The mean cervical dilatation in the vaginal group was 7.8 mm. The mean cervical dilatation was in the higher in the sublingual group. The mean duration of procedure in the sublingual group was 7.76 min. The mean duration of procedure in the vaginal group was 10.44 min. The duration of procedure was lower in the sublingual group compared to vaginal group. The mean intraoperative blood loss in the sublingual group was 16.66 ml compared to 19.3 ml in the vaginal group. The intraoperative blood loss was less in the sublingual group. The pain score in the sublingual group was 1.94 compared to 2.88 in the vaginal group. The pain score was less in the sublingual group compared to vaginal group. The side effects like nausea, vomiting, fever, diarrhea and shivering, was 1.52 in the sublingual group. In the vaginal group it was 0.84. The incidence of side effects was more in the sublingual group. The vaginal bleeding in the sublingual group was 1.34 and in the vaginal group was 0.84 which is higher in the sublingual group. Conclusion: The sublingual group had significant cervical dilatation, less time duration of procedure and lower pain score. Intra operative blood loss was less in sublingual group. Side effects like abdominal pain, nausea, vomiting, shivering was more in the sublingual group. The sublingual group route is convenient to use, avoids vaginal application and comfortable to the patients.