A randomized controlled trial comparing powdery sublingual misoprostol and sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy

Objectives  To compare complete abortion rate, duration of abortion, and side effects between 600 μg powdery sublingual misoprostol and 600 μg sublingual misoprostol tablet for management of embryonic death or anembryonic pregnancy. Materials and methods  Fifty-four pregnant women up to 13 weeks of gestation diagnosed with embryonic death or anembryonic pregnancy were randomized to receive 600 μg powdery sublingual misoprostol or 600 μg sublingual misoprostol tablet. Complete abortion was evaluated by transvaginal ultrasound at 48 h. Results  Twenty-six patients received 600 μg powdery sublingual misoprostol and 28 patients received 600 μg sublingual misoprostol tablet. Complete abortion rate was 34.6% in powdery sublingual misoprostol group and 32.1% in sublingual misoprostol tablet group (P = 0.847). Duration of abortion in powdery sublingual misoprostol group and sublingual misoprostol tablet group was similar (34.7 ± 18.8 vs. 36.9 ± 17.8 h, respectively, P = 0.656). There was no significant difference in the side effects between both groups. Conclusions  Single dose of 600 μg of powdery sublingual misoprostol does not improve its efficacy for management of embryonic death or anembryonic pregnancy when compared to sublingual misoprostol tablet.