Abstract Objectives: To compare oral, buccal and vaginal administration of Misoprostol following oral Mifepristone, in terms of Safety, Efficacy (completion of abortion) and Patient acceptability of route of administration(Acceptance may be defined as whether the patient was satisfied with the route of administration of misoprostol after termination of pregnancy). Study Design: A prospective open label randomized study. Materials and Methods: All pregnant women with less than 9 weeks who presented to R. L. Jalappa Hospital for Medical Termination of Pregnancy between March 2014 and June 2015 were included in this study. Total number of 90 patients included in this study. Patients were divided into 3 groups by computerized randomization plan 17213 and each group comprised 30 patients. Results: Majority of the women were multi gravida(71.1%). Age distribution was similar in all 3 groups, majority of whom belonged to the age group between 21 and 25 years. Most common indication for termination of pregnancy was unplanned pregnancy. Patients in oral (4.3 ± 2.88 hours) and buccal (4.325 ± 2.17 hours) group had shorter induction to expulsion duration compared to vaginal group (5.79 ± 2.42 hours) which was statistically significant. Induction to expulsion duration was reduced with lesser gestational age in all the three groups. Success of complete expulsion was more with buccal route (93.3%). However, this was not significant statistically (P value0.69). Side effects were similar in all the groups except diarrhoea which was significantly more in oral group (P value <0.001). However vaginal group had comparatively least side effects, but not significant statistically. Patient acceptance was similar in all the groups. However in oral and buccal groups, they are able to self administer the drug avoiding the vaginal route of administration. conclusion: The induction to expulsion interval was similar in oral and buccal routes but vaginal route had significantly prolonged duration. Vaginal route had comparatively least side effects while oral route had highest. Buccal route had shorter induction to expulsion interval, minimal side effects and better acceptance of the route of administration.
Keywords: Mifepristone; Misoprostol; Abortion.