A randomized clinical study of mifepristone in combination with various administration of misoprostol for medical abortion

Objective:To evaluate the efficacy of mifepristone in combination with various administration of misoprostol for medical abortion.Methods:A total of 158 healthy women requesting medical abortion and up to 56 days gestation were recruited into this study. To terminate pregnancy they took 25 mg mifepristone orally t.i.d, for two days. Following mifepristone, women were randomized to use on 3rd morning:(1)oral misoprostol 400 μg and vaginal misoprostol 400 μg or (2) sublingual misoprostol 400 μg and vaginal misoprostol 400 μg.Results:In total, the complete abortion rate was 94.9~4, while 92.5% and 97.4% respectively in oral group and sublingual group (P0.05); The failure rate was 0.63%, while zero and 1.28% respectively in oral group and sublingual group (P0.05); The incomplete abortion rate was 4.43%, while in oral group it was 7.5% (6/80), much higher than that in sublingual group (1/78, 1.28%) (P0.05), however, there was no significant difference between two groups. The mean induction-to-abortion interval was 2.39±1.20 h in the oral group, significantly shorter than that in the sublingual group (2.98±1.33) h (P0.01).There was significant difference between two groups.Conclusion:Mifepristone in combination with sublingual misoprostol results in lower incomplete abortion rate as compared with mifepristone plus oral misoprostol (though the difference was insignificant probably due to small sample size).The reason may be that sublingual misoprostol can maintain the effective serum concentration for longer time, and has the highest bioavailability.So the sublingual administration of misoprostol would become a promising method of medical abortion.