A comparison of Clinical Efficacy of Intravaginal Misoprostol with Intravenous Sulprostone for Termination of Second-Trimester Pregnancy

Kim, Jeong Kyu; Moon, Jong Pil; Kim, Yong Beom; Ji, Ill Woon; Jeong, Eun Hwan; Kim, Hak Soon

Abstract

OBJECTIVE
Our purpose was to compare the clinical efficacy of intravaginal misoprostol and that of intravenous sulprostone for termination of second-trimester pregnancy.
METHODS
The patients were assigned to misoprostol and sulprostone group, and the misoprostol group was further divided into two groups according to gestational age. In the misoprostol group, the patients at or before 20 weeks of gestation received 400 microgram of intravaginal misoprostol every 4 hours until labor pain was established, 200 microgram every 6 hours after 20 weeks of gestation. In the sulprostone group, intravenous sulprostone was infused at the speed of 100 microgram/hr after cervical ripening with 3 mg of intravaginal dinoprostone.
RESULTS
At or before 20 weeks of gestation, the median time from induction to completion of termination was longer, but the success rate within 24 hours was less in the misoprostol group than in the sulprostone group (18.75 vs. 7.15 hours, p=0.015; 50% vs 92%, p=0.014, respectively). After 20 weeks, there was no significant difference in median induction time or success rate within 24 hours (5.54 vs. 8.0 hours, p>0.05; 100% vs. 100%, p>0.05, respectively). There was no significant difference in the prevalence of complication or change of hemoglobin after termination between two groups.
CONCLUSION
Sulprostone may be more effective for termination of pregnancy at or before 20 weeks of gestation and misoprostol may be as effective as sulprostone after 20 weeks of gestation. But considering less cost and complication, the efficacy of misoprostol should be further investigated for termination of second- trimester pregnancy.