Can we use a lower intravaginal dose of misoprostol in the medical management of miscarriage? A randomised controlled study

Abstract

Four hundred-microgram misoprostol PV can be recommended for the medical management of miscarriage on an outpatient basis.

Utility of βhCG monitoring in the follow‐up of medical management of miscarriage

“…The study cohort comprised 178 (67.4%) miscarriages; Figure 1b is a flowchart outlining analysis of the study cohort. All cases attended the TVUS on median Day 7 (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Similarly, the median follow-up interval for %ΔβhCG calculation was seven (range 3-21) days.…”

“…The study population comprised of women requesting medical management of missed miscarriage before 13 weeks who participated in a randomised controlled trial (ACTRN12612000150842) 6 of intravaginal 400 μg versus 800 μg misoprostol, repeated once the next day as clinically indicated, conducted between May 2007 and July 2010. The trial protocol and clinical outcomes have previously been published.…”

“…The trial protocol and clinical outcomes have previously been published. 4,6 We calculated the %ΔβhCG from the blood samples collected prospectively during this trial and evaluated %ΔβhCG in a secondary analysis of the trial outcomes. The study was approved by our Human Research Ethics Committee (MHS/976M).…”

“….0% of cases with high rates of patient satisfaction. [6][7][8] How best to follow up misoprostol use is unresolved. Medical management does not obviate the need for surgery [6][7][8] and clinicians want to recognise failure.…”

“…[6][7][8] How best to follow up misoprostol use is unresolved. Medical management does not obviate the need for surgery [6][7][8] and clinicians want to recognise failure. [9][10][11] As clinical assessment may be unreliable, 4 ultrasound assessment has been the principal method to evaluate treatment outcome.…”