Intravaginal Misoprostol for Termination of Midtrimester Pregnancy

EDITORIAL COMMENT: We accepted this paper for publication because readers will be interested to see this alternative method for termination of second-trimester pregnancy to that reported in the preceding paper by Prasad and colleagues. We agree with the authors that trials comparing intravaginal misoprostol with other prostaglandins are required. Such a study of a prospective, randomized trial comparing the efficiency and safety of misoprostol with that of prostaglandin E* in 55 women between 12–22 weeks' gestation, has recently been reported (Jain JK, MishellDR. A comparison of intravaginal misoprostol with prostaglandin E₂for termination of second-trimester pregnancy. New Engl J Med 1994; 331:290–293). This study concluded that misoprostol was at least as effective as PGE₂ and was less costly, easier to administer, and associated with fewer adverse effects.
Summary: Misoprostol seems to be a drug with many potential uses apart from the treatment of gastric and duodenal ulcers. The oral tablet appears to be effective for termination of midtrimester pregnancy when administered intravaginally. Further research should be carried out to determine its full range of action in order that the drug can be utilized to its maximum potential.