The researchers did this study to compare the efficacy and safety of intravaginal misoprostol 200 µg, 400 µg, and gemeprost regimens for second-trimester TOP.

A three-armed randomized controlled trial where 116 women undergoing second-trimester TOP were given intravaginal misoprostol 200 µ g, misoprostol 400 µg, or gemeprost 1 mg at 4- hour intervals until abortion occurred with a maximum of five doses.

The misoprostol 400 µg group had the highest incidence of successful abortions than the misoprostol 200 µg and gemeprost 1 mg within 48 hours. There was no significant difference in abortion rate between misoprostol 200 µg and gemeprost. The misoprostol 400 µg group had the highest fever incidence compared to misoprostol 200 µg and gemeprost 1 mg. The gemeprost group had the highest diarrhea incidence compared to misoprostol 400 µg and misoprostol 200 µg groups.

The study concluded that intravaginal misoprostol 400 µ g at 4- hour intervals was the most effective regimen but was associated with a high fever incidence. Misoprostol 200 µg demonstrated similar effectiveness as gemeprost and had a lower incidence of diarrhea.

Reference: https://srh.bmj.com/content/43/4/252

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