Akoury 2004.

Methods	Computer‐generated randomisation sequence with stratification for participating centre and gestational age (≥20 weeks versus < 20 weeks) using blocks of 6. A central office allocated study patients to groups using sealed opaque envelopes. Women were randomly assigned.
Participants	136 pregnant women (group I: 84, group II: 52) Inclusion criteria: singleton, live fetus at 15 to 24 weeks’ gestation with a complex fetal anomaly and/or abnormal fetal karyotype were included. Exclusion criteria: allergy to prostaglandins, a previous classic cesarean section or hysterotomy, active bleeding, severe asthma, severe oligohydramnios, pre‐labor rupture of membranes.
Interventions	Group I: 400 mg of misoprostol in the posterior fornix of the vagina every 4 hours for a total of 6 doses or until delivery occurred. If after 24 hours no labor commenced, an intravenous solution of oxytocin, 100 U/of L Ringer’s lactate at 100 mL per hour, was commenced. Group II: 400 μg misoprostol orally every 4 hours for a total of 6 doses or until delivery occurred. If after 24 hours no labor commenced, an intravenous solution of oxytocin, 100 U/of L Ringer’s lactate at 100 mL per hour, was commenced.
Outcomes	Primary outcome: time from the start of the procedure to placental delivery. Secondary outcomes: incidence of major and minor maternal complications, women’s views of the method and the success rate for culture of fetal umbilical cord.
Notes	In this study, women were randomly assigned to 1 of 3 groups: intra‐amniotic PGF2a, vaginal misoprostol, or oral misoprostol. (n=217). The women receiving PGF2a were excluded from our analyses, because of the use of laminaria. Definition of abortion: expulsion of the fetus and placenta. No clear information was provided regarding the policy of evacuation of the uterus. No major complications occurred.
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ adequate
Blinding? All outcomes	High risk
Free of other bias?	Low risk	No statistically significant differences between the groups in terms of maternal age, gestational age and parity.