A Preliminary Comparison of Efficacy of Intravaginal Misoprostol with Intravenous Sulprostone for Termination of Second-Trimester Pregnancy

Lee, Sang Kyoung; Kim, Man Gi; Kim, Yu Re; Hong, Seung Hwa; Park, Yeon Jin; Ji, Ill Woon; Jeong, Eun Hwan; Kim, Hak Soon

Abstract

OBJECTIVE
The purpose of this study was to compare the efficacy of intravaginal misoprostol and that of intravenous sulprostone for termination of second-trimester pregnancy.
METHODS
Fouty-six patients were randomly 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 regardless of gestational age.
RESULTS
At or before 20 weeks of gestation, the mean time from induction to completion of termination was shorter, and the success rate within 24 hours was higher in the misoprostol group than in the sulprostone group (9.0 vs. 20.2 hours; 86% vs 50%). After 20 weeks, the mean induction time was longer at misoprostol group than sulprostol group but, there was no significant difference in success rate within 24 hours (14.7 vs. 7.1 hours; 83% vs. 86%). There was no significant difference in the prevalence of complication between two groups.
CONCLUSION
Misoprostol is superior to sulprostone for termination of pregnancy at or before 20 weeks of gestation, but both have almost equal effectiveness after 20 weeks of gestation. Considering less cost and complication, the efficacy of misoprostol should be further investigated for termination of second-trimester pregnancy.