Intravaginal Isoniazid (INH) and Sublingual Misoprostol Versus Sublingual Misoprostol Alone for First-Trimester Induced Abortion: A Randomized Controlled Trial

This study aimed to compare sublingual misoprostol alone or combined with vaginal Isoniazid (INH) for first-trimester abortion.  

In this randomized controlled trial, 80 pregnant women with missed abortion candidates for first-trimester abortion were randomly assigned to two groups. The first group received 800 μg sublingual misoprostol every three hours maximum for three doses and the second group received 1500 mg vaginal INH followed by the same dose of misoprostol. Vaginal sonography was performed after 24 hours on both groups to observe any retained product of conception. In case of no response or incomplete abortion, the  second course of misoprostol (with the same dose) was administered. The abortion (complete or incomplete) rate was reported within 48 hours after the first dose of misoprostol.  

The rate of successful intervention (either complete or incomplete) abortion within 48 hours of misoprostol administration was 75% in both groups and was not significantly different (P value = 1). Also, hospitalization duration, abortion time, total misoprostol dosage, and the rate of side effects were similar in the two groups. Five patients in the misoprostol group and three in the misoprostol plus isoniazid group underwent emergent D&C because of heavy bleeding.  

A combined regimen of sublingual Misoprostol plus vaginal Isoniazid with the prescribed dosage has similar efficacy to sublingual misoprostol alone in first-trimester abortion.