Comparison of the Effectiveness of Sub Lingual Vs Vaginal Misoprostol in Termination of First Trimester Missed Abortion

Effectiveness of Sub Lingual Vs Vaginal Misoprostol in Termination of First Trimester

Abstract

Background: The incidence of spontaneous miscarriages increases with age. In the first trimester, the leading cause of spontaneous abortion is embryonic abnormalities, responsible for 80-90% of all miscarriages. Miscarriage affects 10-20% of clinically recognized pregnancies. Objective: To compare the effectiveness of sublingual versus vaginal routes of misoprostol in termination of first trimester missed abortion. Study Design: Quasi-experimental trial. Settings: Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar Pakistan. Duration: March, 2022 to March, 2023. Methods: The study enrolled 78 participants, equally divided into two groups, Group-A receiving misoprostol sublingually while Group-B receiving vaginal misoprostol. Data collected was analyzed using SPSS version 20, with a p-value <0.05 considered significant. Results: The mean age of participants in the sublingual group was 30 years (SD±4.24), while in the vaginal group, it was 26 years (SD±5.22). The mean gestational age was similar in both groups, about 10 weeks. Women aged 31-45 years experienced significantly higher failure rates in the vaginal group (15.38%) compared to the sublingual group (2.56%) with a p-value of 0.027. Additionally, a shorter induction-to-abortion interval of less than 12 hours was associated with a higher failure rate in the vaginal group (5.12%) vs the sublingual group (20.51%), with a p-value of 0.027. Conclusion: Our study found that misoprostol administration through sublingual route is effective than vaginal route for the medical management of missed miscarriage but the results obtained were not significant statistically.