Comparing Buccal and Vaginal Misoprostol in Management of Early Pregnancy Loss
Status:
Completed
Trial end date:
2016-06-01
Target enrollment:
Participant gender:
Summary
First trimester miscarriages are common. When the failed pregnancy does not pass
spontaneously on its own, it is called a missed abortion. There are several ways in which
missed abortions are managed, one of which involves administering a medication called
misoprostol which causes uterine contractions inducing expulsion of the failed pregnancy.
Misoprostol can be administered in multiple ways but has been traditionally inserted
vaginally when used for management of missed abortions. Some studies have shown that some
women are not comfortable with vaginal insertion of misoprostol and prefer oral
administration. Buccal misoprostol is a way of administering misoprostol by having the
patients insert the tablets of misoprostol between their gum and cheek, letting it dissolve
for 30 minutes, then swallowing the remaining remnants. Buccal misoprostol is used safely in
medical abortion. In fact a study by Fjerstad et al (2009), found a decrease in infection
rate for medical abortion when misoprostol administration was switched from vaginal to buccal
route combined with routine administration of doxycycline. The efficacy of using buccal
misoprostol to treat missed abortions has not been studied previously to the investigators'
knowledge. In this pilot study, investigators aim to test the hypotheses that buccal
misoprostol is equally effective as vaginal misoprostol in the medical management of early
pregnancy loss. As secondary outcomes, investigators suspect that buccal misoprostol may be
associated with higher rates of gastrointestinal side effect but that patient satisfaction
will remain equally as high for buccal misoprostol as for vaginal misoprostol.