A randomized controlled trial comparing powdery sublingual misoprostol and sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy.

Author(s): Saichua C, Phupong V

Affiliation(s): Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.

Publication date & source: 2009-09, Arch Gynecol Obstet., 280(3):431-5. Epub 2009 Feb 4.

Publication type: Comparative Study; Randomized Controlled Trial

OBJECTIVES: To compare complete abortion rate, duration of abortion, and side effects between 600 microg powdery sublingual misoprostol and 600 microg sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy. MATERIALS AND METHODS: Fifty-four pregnant women up to 13 weeks of gestation diagnosed with embryonic death or anembryonic pregnancy were randomized to receive 600 microg powdery sublingual misoprostol or 600 microg sublingual misoprostol tablet. Complete abortion was evaluated by transvaginal ultrasound at 48 h. RESULTS: Twenty-six patients received 600 microg powdery sublingual misoprostol and 28 patients received 600 microg sublingual misoprostol tablet. Complete abortion rate was 34.6% in powdery sublingual misoprostol group and 32.1% in sublingual misoprostol tablet group (P = 0.847). Duration of abortion in powdery sublingual misoprostol group and sublingual misoprostol tablet group was similar (34.7 +/- 18.8 vs. 36.9 +/- 17.8 h, respectively, P = 0.656). There was no significant difference in the side effects between both groups. CONCLUSIONS: Single dose of 600 microg of powdery sublingual misoprostol does not improve its efficacy for management of embryonic death or anembryonic pregnancy when compared to sublingual misoprostol tablet.