Department of Pharmacology, Government Medical College, Srinagar (Kashmir), Jammu & Kashmir, India.
Indian J Pharmacol. 2011 Apr;43(2):172-5. doi: 10.4103/0253-7613.77356.
To compare the effectiveness and tolerability of misoprostol as a cervical ripening agent in first trimester abortion through three different routes of administration before surgical evacuation (SE).
It was a hospital based prospective randomized open labeled parallel study. A total of 150 randomly selected married women were divided in three groups for sublingual (S/L), vaginal and oral 400 μg of misoprostol single dose administration. The drug was administered 3-4 h before SE in the S/L and vaginal groups and 12 h before the procedure in the oral group. Efficacy was assessed on the basis of time taken for ripening, dilatation achieved, duration of the procedure, intra-operative blood loss, and pain score. The tolerability was noted on the basis of side effects.
The mean time taken for cervical ripening was less in sublingual administration (3.7±1.2 hr) as compared to the vaginal and oral routes. The S/L group had significant cervical dilatation (P<0.001) and the duration of SE was less as compared to the vaginal and oral routes. However, the mean intraoperative blood loss was more in sublingual as compared to the vaginal and oral groups. The intra-operative pain score of the S/L group was significantly lower (1.9±1.1, P<0.05) as compared to the vaginal (2.6±1.7) or oral route (3.3±1.7). Loose motions and nausea/vomiting were more with the S/L and oral routes while blood loss was more in the vaginal route.
Administration of misoprostol by the sublingual route is better than the oral and vaginal routes for cervical ripening.
比较三种不同给药途径（经阴道、口服）的米索前列醇在手术流产（SE）前用于早孕引产的效果和耐受性。
这是一项基于医院的前瞻性随机开放标签平行研究。总共随机选择了 150 名已婚妇女，分为舌下（S/L）、阴道和口服 400μg 米索前列醇单剂量给药三组。S/L 和阴道组在 SE 前 3-4 小时给药，口服组在手术前 12 小时给药。根据成熟时间、达到的扩张程度、手术持续时间、术中出血量和疼痛评分评估疗效。根据副作用来评估耐受性。
与阴道和口服途径相比，舌下给药的宫颈成熟时间更短（3.7±1.2 小时）。S/L 组宫颈扩张明显（P<0.001），SE 持续时间较阴道和口服组短。然而，与阴道和口服组相比，S/L 组术中出血量更多。与阴道组（2.6±1.7）或口服组（3.3±1.7）相比，S/L 组术中疼痛评分显著较低（1.9±1.1，P<0.05）。S/L 和口服组出现腹泻和恶心/呕吐的情况更多，而阴道组出血更多。
与口服和阴道途径相比，舌下给药米索前列醇用于宫颈成熟效果更好。
