Medical management of first trimester incomplete miscarriage using misoprostol

Abstract

This prospective study looked at the effectiveness of 400 microg oral misoprostol in the management of women with a first trimester incomplete miscarriage with retained products of conception measuring between 15 mm and 50 mm on transvaginal ultrasound scan. Of 164 eligible women, 131 agreed to participate. Successful treatment, defined as an empty uterus on scan after 10 days with no bleeding, was achieved in 77.7% of women. Some women with retained products opted to have further misoprostol or conservative management instead of surgical evacuation and in total 92.4% of women completed their miscarriage without requiring surgery. Most bleeding was mild (31.3%) to moderate (38.9%), lasting on average 6.4 days. Forty-five per cent of women needed no pain relief, 51% received oral analgesia and 4% intramuscular opiates. Adverse effects included nausea (10.93%), diarrhoea (2.34%), vomiting (7.8%) and hypotension (4.68%). There were no infections. We concluded that a single dose of 400 microg of oral misoprostol was an effective treatment for women presenting with an incomplete miscarriage.

Saving maternal lives in resource-poor settings: Facing reality

“…Table 4 is a list of studies and their results/ recommendations on using misoprostol alone for both elected and missed abortions as well as PAC. Evidence indicates that misoprostol-alone is a safe and effective means to induce abortion or treat abortion complications [24][25][26][27][28][29][30][31][32][33]. Furthermore, researchers have found that misoprostol is as effective and as acceptable to women as MVA, and thus well-suited for low-resource settings [34][35][36].…”

Isosorbide Mononitrate versus Misoprostol for Cervical Ripening in Early Missed Abortion

“…Tables (3,4) summarize the comparison of the efficacy between the two study groups. Comparing the ripening effect of both groups after each dose given it was found that after the 1 st and 2nd doses of the misoprostol group the number of cases with successful ripening was 8% & 12% respectively and in the IMN group for the same doses the results were 3% & 7% respectively; while the peak effect of the misoprostol group between the 3 rd and 4th doses was 46% and 27% respectively, in the IMN group the peak between the 4th and 5th doses was 17% and 38% respectively.…”

“…Moreover surgical evacuation could be needed owing to failure, so intervention is better either medical or surgical. Traditionally, the first trimester miscarriage, is terminated by surgical evacuation of the uterus [3,4] . Although, this procedure was introduced to reduce the risk of infection and hemorrhage, it is reported to be associated with many complications including cervical trauma, perforation of the uterus, endometritis and cervical incompetence [5] .…”

Tratamiento médico del aborto espontáneo del primer trimestre

“…El atractivo de los métodos clínicos para la evacuación del aborto espontáneo es justamente que ofrecen la posibilidad de cumplir con estos requisitos 161 .…”