Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Urology

To compare the effect and complications of sublingual versus vaginal administration of misoprostol for pre- operative cervical priming before surgical evacuation of pregnancy in first trimesteric missed abortions. 80 women diagnosed with first trimesteric missed abortion were randomized into either sublingual or vaginal groups of 40 each. They were given 400 æg misoprostol via sublingual or vaginal route for cervical priming 4 hours before the procedure. The outcome measures assessed were cervical dilatation (1ry) before surgery, duration of procedure, intraoperative blood loss, post abortive Et by U / S, post abortive bleeding and preoperative side effects. Subjects in the sublingual group achieved significantly higher mean cervical dilatation compared to vaginal group (8.63 ± 1.58 mm vs. 7.62 ± 2.22 mm, p = 0.03). The mean duration of procedure for sublingual group was significantly lower compared to the vaginal group (4.7 ± 1.87 minutes vs. 5.65 ± 2.48 minutes, p = 0.01). The intraoperative blood loss in both groups was found to be of no statistically significant difference same for post abortive bleeding. There was no statistically significant difference between both groups as regard ET by U / S. The sublingual group experienced more nausea and vomiting as compared to vaginal group. The vaginal group experienced more tachycardia and abdominal pain, which were statistically insignificant differences. Sublingual misoprostol is more effective and convenient route than vaginal misoprostol for preoperative cervical priming in first trimester abortion

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