A Prospective, Randomized, Controlled Trial On The Use Of Mifepristone With Sublingual Or Oral Misoprostol For Medical Abortion

Objective In order to raising the efficacy and acceptability of the medical abortion, explore the best route and the best dose of administration of misoprostol.Methods In trial one, 162 women up to 7 weeks gestation were randomized to receive 600μg or 400μg of misoprostol sublingually, or receive 600μg of misoprostol orally. In trial two, 104 women between 10 and 14 weeks gestation were randomized to receive 400μg of misoprostol sublingually or 600μg of misoprostol orally. Compared the efficacy of medical abortion and the side effects. Follow-upped and evaluated the complete abortion's rates. The plasma concentration of misoprostol acid (MPA) at the time of 30min after administrating misoprostol was assayed using high-pressure liquid chromatography/mass spectrometry (HPLC/MS).Results1. The complete abortion's rates of the three groups in trial one were 96.15%, 94.00% and 90.20% (P>0.05). The meaninduction-to-abortion intervals were 119.69 + 38.76min, 124.15 + 43. 75min and 155. 78 + 67. 41min (P<0.01). There was no significant difference between the two sublingual groups (P>0.05), however the two sublingual groups' induction-to-abortion intervals were both significantly shorter than the oral group (PO.01). There was no significantly difference in side effects among the three groups CP>0.05).2. In trial two, the passage of fetus' rate in 8h was higher in the sublingual group (90.38%) than the oral group(82.35%) CP>0.05). The mean interval between misoprostol and passage of fetus was significantly shorter in the sublingual group(181. 89 + 76. 40min) than the oral group(224. 63 + 74.17min) (P<0.05). There was no significantly difference in side effects between the two groups (P>0.05).3. The plasma concentration of MPA of the three groups in trial one were 913.47 + 378.76 pg/mL, 598.43 + 352.32 pg/mL and 441.61 ±379. 75 pg/mL, (P<0.05). A negative correlation was seen between the induction-to-abortion interval and the plasma concentration of MPA(r=-0.682,P<0.01).Conclusion1. Sublingual route resulted in the better efficacy of medical abortion than oral route both in trial one and trial two, so sublingual...