Comparison of Management of Missed Abortion by Medical and Surgical Method [Intravaginal Misoprostol Vs Suction Evacuation]

Singh, Nishi; Aggarwal, Rajni; Shikha, Deep; Goel, S. K.

doi:10.5958/2321-1024.2018.00040.5

Cited by 1 publication

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“…Misoprostol, a synthetic prostaglandin agonist originally used to treat peptic ulcer, was accidentally discovered to be an abortifacient agent. Compared with a surgical method, it has been the focus of many studies, regarding its dosing and route of administration, either alone or in combination with other drugs, with varying success rates and safety profiles [3,4]. Treatment failure is a well-acknowledged subject by most obstetric practitioners and has been investigated by many researchers; some relate it to maternal parameters and others to the drug chosen.…”

Section: Introductionmentioning

confidence: 99%

To operate or to wait? Doppler indices as predictors for medical termination for first trimester missed abortion

Nori¹,

Abdulghani²,

Roomi³

et al. 2021

Clin. Exp. Obstet. Gynecol.

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Missed abortion is a common obstetrical problem with a high incidence. Evidence supports a change in approach from the traditional dilatation and curettage to medical; however, few studies have investigated the prediction success of the medical approach. This study investigates whether first trimester missed abortion can be successfully terminated using Doppler indices, such as resistance index (RI) and pulsatility index (PI), as predictors. Material and Method: In this prospective study, the sample is made up of 78 patients, with a first trimester missed abortion range of 6-13 weeks of pregnancy who meets the maternal parameters as well as transvaginal Doppler indices, RI and PI. The participants were subdivided into 3 groups based on their response to sublingual misoprostol and weeks needed to terminate as Groups I (43/78), II (26/78), and III (9/78) aborted in the first, second, and third weeks, respectively. Results: Age, BMI, and gestational age of dead fetus were not significant for Groups I, II, and III with P = 0.13, P = 0.13, and P = 0.35, respectively. Parity and delivery mode showed significant di ferences (P < 0.0001) between group means of PI and RI. PI for Group I plus II and Group III are 1.53 (0.75-2.70) and 1.58 (1.10-2.10), respectively. RI for Group I plus II and Group III are 0.71 (0.50-1.00) and 0.80 (0.69-0.92), respectively. The coe ficient of correlation proves that RI is the primary predictor of successful termination of a first trimester missed abortion with a cut-o f value of 0.74 with associated sensitivity and specificity of 68.7% and 56.7%, respectively. Conclusions: Increased parity and a history of vaginal delivery, in addition to measured RI, were predictors of successful termination of a first trimester missed abortion. These results may be used in counseling patients to decide safest and most suitable option to terminate a first trimester missed abortion, depending on their demographic criteria and ultrasound scores.

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Section: Introductionmentioning

confidence: 99%