Comparison between the sublingual and oral route of misoprostol for pre-abortion cervical priming in first trimester abortions.

Background: Misoprostol has been used for achieving cervical priming before suction evacuation (SE) by the oral or vaginal route, although both routes have their shortcomings. We evaluated the efficacy of the sublingual versus oral route of misoprostol for cervical priming before SE.

Methods: A prospective clinical trial was carried out in 100 women with a period of gestation of between 6 and 12 weeks who were sequentially allocated to two groups of 50 each. Both groups received 400 microg of misoprostol 3 h prior to SE by either the sublingual or the oral route.

Results: Demographically, both groups were similar. For all periods of gestation, sublingual misoprostol significantly improved cervical dilation (P<0.001) with a reduction in duration of surgery (P=0.024) compared with the oral route. Mean (+/- SD) pain scores for the sublingual and oral groups were similar (2.6 +/- 1.4 versus 3.5 +/- 1.1). No major complications occurred in either of the two groups.

Conclusion: the sublingual route is an effective alternative to oral administration of misoprostol for cervical dilation. To the best of our knowledge, this is the first study to compare the efficacy of the sublingual versus the oral route of misoprostol for cervical priming before SE.