Comparison of therapeutic and side effects of misoprostol moistened with normal saline and acetic acid in induced abortion

  Background: Progress in the early diagnosis of fetal abnormalities and maternal life threatening diseases has increased the rate of second-trimester pregnancy termination.   Objective: The aim of this study was to compare the therapeutic and side effects of misoprostol moistened with normal saline and with acetic acid in second-trimester pregnancy termination.   Methods: In this randomized clinical trial study, 91 pregnant women in second trimester were randomly allocated to receive vaginal misoprostol moistened with acetic acid (47 cases) or with normal saline (44 cases) in Mahdieh hospital, Tehran. The successful abortion rate, induction-abortion interval, mean dose of misoprostol and adverse effects were compared between two groups using Chi-square test and T-test.   Findings: The abortion rate within 24 h was 85.1% and 56.8% in the acetic acid group and normal saline group, respectively. The mean induction-abortion interval was 26.5±21.3 and 15.7±14.2 hours in the normal saline group and acetic acid group, respectively. The mean dose of misoprostol was 1115±570 and 775±400 µg in the normal saline group and acetic acid group, respectively. The side effects and retained placenta were similar in both groups.   Conclusion: Moistening with acetic acid can increase the efficacy of misoprostol in second-trimester pregnancy termination and can decrease the dose of required medication.