Background: Misoprostol is a successful abortion medication when administered vaginally, orally, or sublingually. we aimed for comparing safety in addition to efficacy of different regimens for missed abortion termination of through using sublingual misoprostol, vaginal misoprostol alone, versus sublingual misoprostol, vaginal misoprostol with insertion of cervical Foley's catheter.

Subjects and methods: This prospective randomized controlled trial included 172 pregnant women. Group A (Sublingual group) that subdivided into 2 subgroups: I (A): 43 patients to whom misoprostol tablet was given sublingually every 4 hours up to 6 doses per day, I (B):43 patients to whom misoprostol tablet was given sublingually every four hours up to six doses per day plus Foley's catheter (18fr) insertion through cervix, Group B (Local “vaginal" group): that subdivided into two subgroups; II (A): 43 patients to whom misoprostol tablet was given vaginally every four hours up to six doses per day, II (B): 43 patients to whom misoprostol tablet was given vaginally every four hours up to six doses per day plus Foley's catheter (18Fr) insertion through cervix.

Results: Sublingual misoprostol plus cervical Foley's cathe-ter insertion is associated with higher success rate and least induction to abortion interval; length of hospitalization, number/total of doses of misoprostol needed for terminating pregnancy and need for hysterotomy.

Conclusion: sublingual misoprostol plus cervical Foley's catheter insertion isbest option for management of pregnant women with missed abortion