Management of Early Pregnency Loss by Surgical Evacuation or Medical Termination Which is a Better Choice?

Abstract

Background and Objective: Comparative efficacy of medical termination has always remained debatable as compared to surgical techniques. The study was designed to assess the safety, acceptability and success of oral Misoprostol as an agent of medical termination as compared to surgical evacuation in cases of early pregnancy loss.Methods: This was a quasi-experimental study conducted in Department of Obstetrics and Gynaecology at Sughra Shafi Medical Complex, affiliated with Sahara Medical College Narowal from August 2017 to February 2019. Diagnosed cases of missed miscarriage before 13 weeks (n = 150) were allocated either for surgical evacuation (n = 50) or medical termination by oral Misoprostol (n = 100) on patients' own choice after counselling. Effective dosage schedule of Misoprostol, its adverse effects, number of days taken for complete expulsion and duration of hospital stay were recorded. Main outcome measure was successful termination.Results: Patients enrolled for surgical evacuation had 100% success rate while those in medical termination had 80% success rate and 20% treatment failure.Significant differences were also observed in symptoms, bleeding and hospital stays between the two groups. Conclusion:Surgical evacuation is still a gold standard method recommended for suitable cases, while medical termination by Misoprostolis low cost, better accepted and effective but has unpredictable outcomes.