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Hum. Reprod. Advance Access published online on July 21, 2005
Human Reproduction, 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.
Received February 21, 2005
Revised May 6, 2005
Accepted June 16, 2005

Article

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

Bulent Yilmaz 1*, Sefa Kelekci 1, Ibrahim Egemen Ertas 1, Serkan Kahyaoglu 1, Murat Ozel 1, Necdet Sut 2, and Nuri Danisman 1

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

* To whom correspondence should be addressed.
Bulent Yilmaz, E-mail: drbulentyilmaz{at}yahoo.com


  Abstract

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.

Keywords: acetic acid/blood pressure/misoprostol/saline/second trimester pregnancy termination.
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