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Hum. Reprod. Advance Access originally published online on May 26, 2005
Human Reproduction 2005 20(9):2648-2652; doi:10.1093/humrep/dei102
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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{at}oupjournals.org

Effects of slow release misoprostol on uterine contractility in early pregnancy

C. Fiala1,3, A. Aronsson1, O. Stephansson1,2 and K. Gemzell-Danielsson1,4

1 Department of Woman and Child Health, Division for Obstetrics and Gynaecology, 2 Department of Medicine, Unit of Clinical Epidemiology, Karolinska Institutet, S-171 76 Stockholm, Sweden and 3 Gynmed Ambulatorium, 1150 Vienna, Austria

4 To whom correspondence should be addressed. Email: kristina.gemzell{at}kbh.ki.se

BACKGROUND: The effect of a novel slow release form of misoprostol (SR misoprostol) on uterine activity during early pregnancy was investigated in a pilot study. METHODS: Thirty women with a pregnancy between 8 and 12 weeks requesting surgical abortion were allocated to treatment according to computerized randomization. SR misoprostol (400 and 800 µg) was compared to 400 µg of conventional misoprostol, all given orally. Intrauterine pressure was recorded using a pressure transducer inserted extra-amniotically and connected to a computer 30 min before treatment until 4 h thereafter when suction curettage was performed. Uterine tonus (mmHg) and contractility in Montevideo Units (MU) were calculated. RESULTS: An increase in uterine tonus occurred after a significantly shorter time interval and was significantly more pronounced following conventional misoprostol compared to SR misoprostol. Regular uterine contractions developed in only a few patients treated with 400 µg conventional misoprostol or 400 µg SR misoprostol. In contrast the increase in uterine contractility (MU) was significantly more pronounced following 800 µg SR misoprostol treatment and was still continuing at 4 h of recording. CONCLUSIONS: SR misoprostol acts less on uterine tonus than orally administered conventional misoprostol but leads to development of regular uterine contractions.

Key words: misoprostol/pregnancy/slow release/sublingual administration/uterine contractility


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A. Aronsson, C. Fiala, O. Stephansson, F. Granath, B. Watzer, H. Schweer, and K. Gemzell-Danielsson
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