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Hum. Reprod. Advance Access originally published online on July 21, 2005
Human Reproduction 2005 20(11):3067-3071; doi:10.1093/humrep/dei204
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Misoprostol moistened with acetic acid or saline for second trimester pregnancy termination: a randomized prospective double-blind trial

Bulent Yilmaz1,3, Sefa Kelekci1, Ibrahim Egemen Ertas1, Serkan Kahyaoglu1, Murat Ozel1, Necdet Sut2 and Nuri Danisman1

1 Zekai Tahir Burak Women’s Health Education and Research Hospital, Department of Obstetrics and Gynaecology, Ankara and 2 Department of Biostatistics, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey

3 To whom correspondence should be addressed at: Camlitepe Mahallesi, Taskent Sokak, 26/8, Kurtulus, 06600, Ankara, Turkey. E-mail: drbulentyilmaz{at}yahoo.com

BACKGROUND: This study was conducted to evaluate the efficacy and side effects of a new regimen of 800 µg misoprostol administered intravaginally every 6 h up to a maximum of three doses in 24 h for second trimester pregnancy termination. METHODS: A total of 66 women seeking termination of second trimester pregnancy (30 fetal structural anomaly, six chromosomal abnormality and 30 fetal death) were randomly assigned to one of two treatment groups: (i) intravaginal misoprostol moistened with 3 ml of 5% acetic acid in group A (n = 33); or (ii) intravaginal misoprostol moistened with 3 ml of saline in group B (n = 33). RESULTS: The overall median (range) induction–abortion interval was 10 h (2–46) [10 h (4–35) in 36 live fetuses and 9 h (2–46) in 30 dead fetuses, P = 0.515]. All of the patients in both groups aborted within 48 h (100% success rate). The median (range) induction–abortion interval revealed a significantly faster delivery time (P < 0.001) in group A [8 h (2–24)] than in group B [14 h (3–46)]. CONCLUSIONS: This new regimen of 800 µg of vaginal misoprostol every 6 h for a maximum of three doses in 24 h was an effective alternative method for second trimester abortion. In addition, misoprostol moistened with acetic acid was significantly more effective than misoprostol moistened with saline.

Key words: acetic acid/blood pressure/misoprostol/saline/second trimester pregnancy termination


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