Comparative Study of Sublingual versus Vaginal Misoprostol on Preoperative Cervical Priming in First Trimester Abortion

Objective: To compare the effect of sublingual versus vaginal misoprostol on preoperative cervical priming in first trimester abortion. Material and methods: One hundred women seeking first trimester abortion were randomized into either sublingual or vaginal groups of 50 each. They were given 400 μg misoprostol via sublingual or vaginal route for cervical priming three hours before the procedure. The outcome measures assessed were cervical dilatation before surgery, duration of procedure, intraoperative blood loss and preoperative side effects. Results: Subjects in the sublingual group achieved significantly higher mean cervical dilatation compared to vaginal group (8.34 ± 0.62 mm vs 7.60 ± 0.67 mm, p = 0.0001). The mean duration of procedure for sublingual group was significantly lower compared to the vaginal group (2.62 ± 0.64 minutes vs 3.17 ± 0.71 minutes, p = 0.0001). The mean intraoperative blood loss was found to be more in sublingual group as compared to vaginal group (34.90 ± 10.90 ml vs 32.90 ± 7.42 ml), but the difference was not significant (p = 0.286). The sublingual group experienced more preoperative side effects such as pain, bleeding, nausea and shivering as compared to vaginal group. Conclusion: Sublingual misoprostol is more effective and convenient route than vaginal misoprostol for preoperative cervical priming in first trimester abortion.