Comparison of cervical ripening in oral versus vaginal misoprostol administration before surgical termination of first trimester pregnancy

Aim: to compare the mean cervical ripening in oral versus vaginal misoprostol administration before surgical termination of first trimester pregnancy. methods: after approval from ethical committee,150 patients,who fulfilled the inclusion and exclusion criteria,were admitted from emergency and opd of dhq hospital,gujranwala. the study was conducted over a periods of six months from january to june 2016. lottery method was used to divide the patients into two equal groups a and b. patients in group a were given 400μg vaginal misoprostol. misoprostol was placed in the posterior formix of the vagina by researcher herself and patients in group b were given 400μg oral misoprostol. the post-medication cervical ripening was measured as per operational definition. all patients then underwent evacuation of retained products of conception,3 hours after administration of tablet. then patients were observed for 2 hours after operation for any allergy or side effects. amoxicillin 500mg and metronidazole 500mg tablets were prescribed to be taken orally for 24 hours after procedure. results: the mean age in group-a (400μg misoprostol vaginally) and in group-b (400μg oral misoprostol) was 26.67±3.93 years and 26.08±5.15 years respectively with similar age distribution. the mean gestational age was 10.93±1.61 weeks in group-a and 10.60±1.62 weeks with no significant difference,p-value > 0.05. the mean cervical dilatation was significantly higher in group-a (6.29±0.85 mm) when compared to group-b (5±0.82 mm),p-value < 0.001. conclusion: we concluded that misoprostol is effective for cervical ripening when administered vaginally before evacuation of products of conception for the first trimester miscarriage.