Open Journal of Obstetrics and Gynecology, 2014, 4, 751-756 Published Online September 2014 in SciRes. http://www.scirp.org/journal/ojog http://dx.doi.org/10.4236/ojog.2014.413104 How to cite this paper: Modak, R., Biswas, D.K., Ghosh, A., Pal, A. and Mandal, T.K. (2014) Comparative Study of Sublingual and Vaginal Misoprostol in Second Trimester Induced Abortion. Open Journal of Obstetrics and Gynecology, 4, 751-756. http://dx.doi.org/10.4236/ojog.2014.413104 Comparative Study of Sublingual and Vaginal Misoprostol in Second Trimester Induced Abortion Rupali Modak 1 , Dilip Kumar Biswas 2 , Arindam Ghosh 2 , Amitava Pal 2* , Tapan Kumar Mandal 2 1 Department of Obstetrics and Gynecology, R. G. Kar Medical College, Kolkata, India 2 Department of Obstetrics and Gynecology, Burdwan Medical College, Burdwan, India Email: * amitava.628@rediffmail.com Received 24 June 2014; revised 20 July 2014; accepted 17 August 2014 Copyright © 2014 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/ Abstract Background: To identify an effective misoprostol-only regime for the termination of second tri- mester pregnancy. Objectives: To compare the efficacy, safety and acceptability of sublingual and vaginal misoprostol for second trimester pregnancy termination. Methods: In a prospective ran- domized comparative study, over 138 pregnant women at 13 - 20 weeks (91 - 140 days) of gesta- tion requiring medical abortion were randomly assigned to the sublingual or vaginal route for misoprostol administration with dose schedule of 400 mcg every 3 hours up to 5 doses within 24 hours. The course of misoprostol was repeated if the woman did not abort within 24 hours. Pri- mary outcome was the efficacy of the treatment to terminate pregnancy completely at 24 and 48 hours. Secondary outcomes measured were induction-abortion interval, side effects, failure rate, and women’s perception to these treatments. Results: At 24 h, the complete abortion rate was 87.88% in the vaginal administration group and 79.41% in sublingual group (difference 8.5%, 95% CI: 3.8 to 13.2). No significant difference in the complete abortion rates was observed at 48 h (90.91% versus 88.24% difference: 2.7%, 95% CI: −0.04 to 5.4) when vaginal and sublingual groups were compared. Mean induction-abortion interval in sublingual and vaginal groups was 12.28 h (95% CI of mean 11.019 - 13.541 h) and 13.11 h (95% CI of mean 12.0301 - 14.1899 h) respective- ly; p = 0.485. The rates of side effects were similar in both groups except for fever, which was more common in vaginal group. Significantly more women in the sublingual group preferred the route as compared to vaginal administration (RR 1.618. 95% CI: 1.277 - 2.050; p < 0.0001). Conclusion: Both sublingual and vaginal routes of misoprostol are equally effective in medical termination of pregnancy in second trimester but sublingual route was preferred by the women. * Corresponding author.