Oral misoprostol versus mifepristone for cervical dilatation before vacuum aspiration in first trimester nulliparous pregnancy: A double blind prospective randomised study

Objective To compare the effectiveness of oral misoprostol and mifepristone for cervical priming before first trimester termination of nulliparous pregnancy. Design Prospective double blind randomised study. Setting Department of Obstetrics and Gynaecology, University of Hong Kong. Participants One hundred nulliparous women undergoing termination of pregnancy between 8 and 12 weeks of gestation were recruited for this prospective randomised trial, The women were allocated to either the oral misoprostol or mifepristone group. Subjects in misoprostol group were given placebo and misoprostol 400 mu g 36 h and 12 h respectively before vacuum aspiration. Subjects in mifepristone group were given 200 mg mifepristone and placebo 36 h and 12 h respectively prior to operation. Main outcome measures Baseline pre-operative cervical dilatation, the incidence of side-effects, the amount of blood loss and duration of procedure. Results There were no significant differences in the baseline cervical dilatation, incidence of side-effects, amount of blood loss and duration of procedure. Conclusions Misoprostol and mifepristone are of similar effectiveness for cervical priming prior to vacuum aspiration in nulliparous women. Misoprostol has additional advantages of being widely available and inexpensive.