1.Second Trimester Medical Termination of Pregnancy with Combined Intracervical and Intravaginal Misoprostol: Comparative Analysis with Intravaginal Misoprostol—A Pilot Study
Gaurav Shyam Desai • Abhishek Chandavarkar • Sriram Gopal • Ganpat Sawant • Shyam V. Desai. The Journal of Obstetrics and Gynecology of India.
The authors in this study selected a dose of 600 lg for intravaginal misoprostol for the control group, as this is the dose commonly employed for second trimester termination of pregnancy. For intracervical placement, a dose level of 200 lg was selected as higher doses have the potential to cause tetanic uterine contractions and the possibility of uterine rupture. Intravaginal placement appears to be easier; however, there is a possibility of reduced absorption of drug in the case of vaginal dryness or reduced vascularity. Intracervical insertion of misoprostol has a better likelihood of the drug staying in situ if the patient is ambulatory but can be tedious if the cervical os is closed.
2.Vaginal Misoprostol vs Vaginal Misoprostol With Estradiol for Labor Induction: A Prospective Double Blind Study
Dasgupta Ellora • Singh Gurneesh. The Journal of Obstetrics and Gynecology of India (January–February 2012) 62(1):47–51
Table 3 shows fetal outcome, doses of misoprostol required, induction—cervical ripening interval, induction—active labor interval, induction—delivery interval and post partum complications. No significant difference was found in pre induction Bishop’s score, fetal outcome and maternal complications. However, doses of misoprostol required for cervical ripening (p = 0.017), time required for cervical ripening (p = 0.042), time required for starting of active labor (p = 0.017) and time required for delivery in vaginal delivery cases (p = 0.047) were found significantly less in combined estradiol and misoprostol group.
3.Efficacy and safety of mifepristone and buccal misoprostol versus buccal misoprostol alone for medical abortion
Krishna Dahiya • Kamlesh Ahuja • Atul Dhingra. Arch Gynecol Obstet (2012) 285:1055–1058
Misoprostol (PGE1) is an inexpensive, orally active, synthetic prostaglandin that is used for the prevention of gastric ulcers. It does not need refrigeration and has few gastrointestinal side-effects. Misoprostol has been used for medical abortion, cervical softening and induction of labor and treatment of postpartum hemorrhage. Various routes of misoprostol administration are currently under study and include oral, vaginal, buccal, sublingual and rectal. In buccal administration, the drug is placed between teeth and cheek and allowed to be absorbed through buccal mucosa. Clinical studies, although limited, compared to other routes
have shown that buccal route is also effective for medical abortion, cervical priming and labor induction.
4.Randomized controlled trial of vaginal misoprostol versus vaginal misoprostol and isosorbide dinitrate for termination of pregnancy at 13–29 weeks
Samir Hidar, Mohamed Bouddebous, Anouar Chaeb. Arch Gynecol Obstet (2005) 273: 157–160
From January 2003 to July 2004, 163 women had second trimester pregnancy termination at our institution. Of these, 114 were eligible and 70 entered the trial. A total of 36 patients were enrolled in the misoprostol-only group of whom 30 completed trial; 34 patients were assigned to the misoprostol plus isosorbide dinitrate group of whom 31 completed the trial (Fig. 1). The clinical characteristics of the two groups are shown in Table 1. The indications for pregnancy termination in both groups are shown in Table 2.