Outcomes of second-trimester pregnancy terminations with misoprostol: comparing 2 regimens

The purpose of this study was compare outcomes of second-trimester pregnancy terminations with misoprostol between our previous low- (200 microg every 12 h) and present high-dose (400 microg every 6 h) regimens.

This was an historic cohort study that was conducted from June 1996 to February 2004 on women undergoing medical termination of pregnancy at 13 to 27 weeks. Exclusion criteria were multiple gestation, placenta previa, and primary use of another medication.

The cohort consisted of 147 women. For the low- (n = 100) and high-dose (n = 47) groups, respectively, median times to delivery were 22.5 vs 13.25 hours (P = .001). More patients in the high-dose group were delivered vaginally within 24 (81% vs 54%; P = .002) and 48 hours (98% vs 84%; P = .014). Fewer patients in the high-dose group required a second abortifacient (6% vs 27%; P = .004). Clinical chorioamnionitis was more common in the high-dose group (P = .03). One patient experienced a uterine rupture and is included in the analysis. Side effects were uncommon and did not differ between groups.

Our present high-dose regimen for misoprostol terminations of pregnancy effects delivery more rapidly without an appreciable increase in side effects or complications.