efficacy of vaginal misoprostol and vaginal washing with 3% acetic acid for first trimester pregnancy termination: a randomized single blind clinical trial

Introduction: this study was conducted to evaluate the efficacy of 800μg vaginal misoprostol after wetting alkaline ph vagina with 3% acetic acid in comparison with 800μg vaginal misoprostol alone in the alkaline ph vagina in terminating first trimester pregnancies. methods: in this clinical trial, a total of 100 healthy women between 20 and 40 years old requesting legal termination of pregnancy before 12 weeks gestation (98 missed cases 50 in group a and 48 in group b and 2 fetus with great anomaly in group b) were randomly assigned to either of the treatment groups to receive 800μg vaginal misoprostol after wetting vagina with three pieces of cotton soaked in 3ml of 3% acetic acid or 800μg vaginal misoprostol alone for induction abortion. pregnant women with active vaginal bleeding, rupture of membrane, coagulopathy, corticosteroid consumption, previous cesarean section and any contraindication of misoprostol using were excluded. duration of extraction or expulsion of the pregnancy product, complications, and treatment failure were collected. data was analyzed using spss 19 by descriptive statistics and statistical tests comprising independent t-test and chi-square. results: totally 14 patients had complete abortion (7 subjects in each group) and 86 had incomplete abortion (43 patients in each group). the success rate was not significantly different between both groups. the overall median induction-abortion interval was 19±14 hour. conclusion: vaginal misoprostol in alkaline ph vagina wetted with 3% acetic acid was not significantly more effective than vaginal misoprostol alone in alkaline ph vagina in first trimester pregnancies.