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Comparison of vaginal misoprostol and gemeprost as pre-treatment in first trimester pregnancy interruption
1Helsinki City Maternity Hospital, Helsinki, Finland.
Objective:
To compare the effectiveness of vaginal misoprostol pre-treatment with standard gemeprost pre-treatment in first trimester pregnancy termination.
Design:
A prospective randomised study.
Population:
One hundred and ninety-nine women scheduled for day case termination of pregnancy during the first trimester.
Methods:
Cervical priming with a vaginally applied 200 microg tablet of misoprostol for at least four hours, compared with a 1.0 mg vaginal suppository of gemeprost for at least three hours before vacuum aspiration.
Main Outcome Measures:
The prostaglandin effect on baseline cervical dilatation was the main outcome. Others were occurrence of pre-operative pain and need for analgesia, pre-operative side effects such as nausea, vomiting and diarrhoea, presence of blood in the vagina and blood loss during the operation.
Results:
There was no significant difference in the dilatation ability of misoprostol or gemeprost, nor in the pre-operative use of analgesics. The frequency of nausea and diarrhoea was significantly less common in the misoprostol treated women.
Conclusions:
Vaginally applied misoprostol is as effective as gemeprost in cervical priming prior to first trimester vacuum aspiration. Misoprostol was associated with fewer side effects than gemeprost.