Sublingual misoprostol for cervical priming in surgical first trimester pregnancy termination

To determine the efficacy of 400 mcg sublingual misoprost as an adjunct to suction evacuation in first trimester pregnancy termination.

During the study period of January2006-June 2007, two hundred twenty-one pregnant women wanting first trimester pregnancy termination were randomised into two groups. In the study group of one hundred twenty-one women, sublingual misoprostol was used 3 h prior to suction evacuation. In the control group of hundred women, direct suction evacuation was used. In cervical dilatation achieved by misoprostol, time required for suction evacuation, blood loss, pain perceived by patient and complications that occurred in the two groups were compared by STATA 9 stastistical software.

In the study group, mean cervical dilatation was up to 5.61 with Hegar dilator and in control group, it was 5.03. (P = 0.004). Average time required for suction evacuation was 7.28 min in study group and 8.73 min in control group (P < 0.0001). Blood loss was less in study group as compared to those in the controls. In study group, only 10.74% women perceived pain compared to twenty percent women in control group.

Use of sublingual misoprost prior to first trimester pregnancy termination by suction evacuation ripens the cervix so there is less need for cervical dilatation, pain perceived by patient is less, the time required for suction evacuation is less and there is reduction in blood loss. Sublingual misoprostol is effective and safe for cervical ripening and dilatation before suction evacuation.