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Misoprostol administration in medical abortion. A comparison of three regimens.

OBJECTIVE
To determine the best regimen for using misoprostol after methotrexate in medical abortion with respect to outcome and side effects.


STUDY DESIGN
In a cohort study, we compared vaginal misoprostol in one cohort of 134 women who used 800 micrograms dry tablets with 99 women who used 600 micrograms wet and 197 women who used 800 micrograms wet. These cohorts were compared with respect to outcome and side effects.


RESULTS
The "dry" group had fewer completed abortions by day 8 (55.2% as compared to 69.7% and 71.1%, P = .008) but similar surgery rates. The dry group also had fewer side effects, especially fever and chills (4.5% as compared to 25.3% and 40.6%, P = .0001) and vomiting (8.2% as compared to 16.2% and 20.3%, P = .01).


CONCLUSION
Of the three methods, the one consisting of 600 micrograms of wet misoprostol is the most effective for early completion of abortion and has the fewest side effects.