Misoprostol for the purpose of mid-trimester termination of pregnancy: a comparative study with prostaglandin F2 alpha.

OBJECTIVE To compare the efficacy of misoprostol verses prostaglandin F2alpha (PGF2alpha) in the medical management of termination of mid-trimester pregnancy due to medical reasons. METHODS This experimental study was conducted in Obstetrics and Gynaecology Department, Bahawal Victoria Hospital, Bahawalpur for a period of 6 months from April 2005 to September 2005. Time interval between induction with misoprostol or PGF2alpha and expulsion of foetus, number of tablets of misoprostol used and total dose of injection PGF2alpha used for termination of pregnancy as well as the complications experienced with both drugs. Fifty patients of 18-35 years of age were randomly selected who presented to Gynaecology and Obstetrics outdoor with mid-trimester foetal loss or congenitally malformed foetus incompatible to life, confirmed on ultrasonography. These women were randomised to receive either intravaginal misoprostol or extra-amniotic PGF2alpha. RESULTS Ninety-six percent of cases were managed successfully with Misoprostol as compared to 92% where PGF2alpha was tried (p > 0.5). Mean induction to expulsion duration for misoprostol and PGF2alpha were 9.02 +/- 4.57 and 16.04 +/- 6.22 hours respectively (p < 0.5). Complications profile was low especially in cases of PGF2alpha and only one case experienced significant haemorrhage. CONCLUSION Misoprostol and PGF2alpha were found to be of same success rate but former was found to be more efficacious in terms of induction to expulsion duration.