Table 7.17GRADE summary of findings for comparison of oral misoprostol with sublingual misoprostol for the management of incomplete miscarriage

Number of studiesDetails of treatment regimen (dose in micrograms unless stated)Number of women or averageEffectQuality
OralSublingualRelative

(95% CI)
Absolute

(95% CI)
Success of medical treatment
1 study

(Paritakul & Phupong, 2011)
Oral: 600 misoprostol (Ms)

Sublingual: 600 Ms
28/32

(87.5%)
27/32

(84.4%)
RR 1.04

(0.85 to 1.26)
34 more per 1000

(from 127 fewer to 219 more)
Low
Need for further intervention
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
2/32

(6.3%)
5/32

(15.6%)
RR 0.4

(0.08 to 1.91)
94 fewer per 1000

(from 144 fewer to 142 more)
Low
Adverse effects: incidence of nausea
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
7/32

(21.9%)
8/32

(25%)
RR 0.88

(0.36 to 2.13)
30 fewer per 1000

(from 160 fewer to 283 more)
Moderate
Adverse effects: incidence of vomiting
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
0/32

(0%)
0/32

(0%)
not calculable (NC)NCModerate
Adverse effects: incidence of diarrhoea
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
5/32

(15.6%)
9/32

(28.1%)
RR 0.56

(0.21 to 1.48)
124 fewer per 1000

(from 222 fewer to 135 more)
Moderate
Adverse effects: incidence of fever/chills
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
9/32

(28.1%)
14/32

(43.8%)
RR 0.64

(0.33 to 1.27)
157 fewer per 1000

(from 293 fewer to 118 more)
Moderate
Incidence of heavy bleeding
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
0/32

(0%)
0/32

(0%)
NCNCModerate
Pain: incidence of pain/cramps
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
8/32

(25%)
10/32

(31.3%)
RR 0.8

(0.36 to 1.76)
62 fewer per 1000

(from 200 fewer to 237 more)
Moderate
Pain: severity/100
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
Mean 22.2 (SD 15.0)

n = 32
Mean 29.1 (SD 21.2)

n = 32
NCMD 6.9 lower

(15.9 lower to 2.1 higher)

(P = 0.139)
High
Satisfaction: reported incidence
1 study

(Paritakul & Phupong, 2011)
Oral: 600 Ms

Sublingual: 600 Ms
28/32

(87.5%)
27/32

(84.4%)
RR 1.04

(0.85 to 1.26)
34 more per 1000

(from 127 fewer to 219 more)
Moderate

CI confidence interval, MD mean difference, Ms misoprostol, NC not calculable, P probability, RR relative risk, SD standard deviation

From: 7, Management of threatened miscarriage and miscarriage

Cover of Ectopic Pregnancy and Miscarriage
Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
NICE Clinical Guidelines, No. 154.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG; 2012 Dec.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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