Medical abortion by mifepristone with sublingual vs vaginal misoprostol: A randomised comparative trial

To compare the success and side effects between the sublingual and the vaginal administration of misoprostol for induced abortion in women treated initially with mifepristone. We administered 200 mg of mifepristone to 117 women who requested termination of pregnancy within 9 weeks duration. Forty eight hours later they were randomized into two groups. Fifty eight women received two doses of misoprostol sublingually 3 hrs apart while 59 women received misoprostol 800 mcg vaginally. They were observed for three hours and returned on day 15 for final assessment. Complete abortion occurred in 96.5% (95% CI: 91-100) of women in the sublingual group and 96.6% (95% CI: 91-100) in the vaginal group. This regimen resulted in complete abortion in all women (100%) when it was administered before 7 weeks gestation. The median induction-to-abortion interval was shorter in women in the sublingual group compared to the vaginal group (P <0.001). Women in the sublingual group experienced more diarrhea (P = 0.005) chills (P <0.001) and fever (P = 0.001). Two doses of sublingual misoprostol administered after mifepristone is an effective alternative route to the standard vaginal administration for medical abortion.