Randomised Study of Sublingual and Oral Misoprostol Following 200mg Mifepristone for Abortion Up to 63 Days Gestation in Moldova

R. Comendant, S. Raghavan, B. Winikoff

Objective: The aim of the study is to determine if a dose of 400 mcg sublingual misoprostol, after mifepritone for early abortion is more effective than the standard dose of 400 mcg of oral misoprostol.

Materials and Methods: Four hundred and eighty women presenting for voluntary termination of intrauterine pregnancy with gestational ages of ≤63 days were enrolled in the study and received 200 mg mifepristone orally in the clinic. They were randomized to take 400 mcg misoprostol either sublingually or orally at home 24 hours following mifepristone administration. Women returned to the clinic two weeks after initial visit for an assesment of abortion status. Women with ongoing, viable pregnancies were offered surgical abortions. Women with non-viable pregnancies or incomplete abortions were offered the option of waiting another week before surgical intervention.

Results: Over 90% of women in both arms had successful abortions without recourse to surgical intervention (92.8% in oral vs. 100% sublingual arms, p=.002). Greater than 94% of women in both groups reported being either satisfied or very satisfied with the method and that side effects were tolerable.

Conclusion: 400 mcg of sublingual misoprostol after 200 mg mifepristone is more effective than 400 mcg oral misoprostol taken after 200 mg mifepristone, and as acceptable as oral misoprostol in inducing abortion in women up to 63 days gestation.