Comparison of the Effectiveness of Sub Lingual Vs Vaginal Misoprostol in Termination of First Trimester Missed Abortion

Background: The incidence of spontaneous miscarriages increases with age. In the first trimester, the leading cause of spontaneous abortion is embryonic abnormalities, responsible for 80-90% of all miscarriages. Miscarriage affects 10-20% of clinically recognized pregnancies. Objective: To compare the effectiveness of sublingual versus vaginal routes of misoprostol in termination of first trimester missed abortion. Study Design: Quasi-experimental trial. Settings: Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar Pakistan. Duration: March, 2022 to March, 2023. Methods: The study enrolled 78 participants, equally divided into two groups, Group-A receiving misoprostol sublingually while Group-B receiving vaginal misoprostol. Data collected was analyzed using SPSS version 20, with a p-value <0.05 considered significant. Results: The mean age of participants in the sublingual group was 30 years (SD±4.24), while in the vaginal group, it was 26 years (SD±5.22). The mean gestational age was similar in both groups, about 10 weeks. Women aged 31-45 years experienced significantly higher failure rates in the vaginal group (15.38%) compared to the sublingual group (2.56%) with a p-value of 0.027. Additionally, a shorter induction-to-abortion interval of less than 12 hours was associated with a higher failure rate in the vaginal group (5.12%) vs the sublingual group (20.51%), with a p-value of 0.027. Conclusion: Our study found that misoprostol administration through sublingual route is effective than vaginal route for the medical management of missed miscarriage but the results obtained were not significant statistically.