Efficacy of Vaginal Misoprostol For Terminating Missed Abortion

Given the prevalence rate of missed abortion and the complications of its surgery and also the propounded controversies about medical treatments and in order to determine the efficacy of vaginal misoprostol in terminating missed abortion cases till 12th weeks of pregnancy, this study has been conducted between Dec. 2004 and Sep. 2004 in Kashan Shabihkhani Hospital. The study was a clinical trial in 80 pregnant women with missed abortion. The patients were categorized randomly in two groups (medical group, surgical group). The women in medical group were given an initial dose of 800 m gr. of vaginal misoprostol and if it was necessary more dose of 400 m gr would be repeated every four hours for maximum of three vaginal or oral dose in proportion of amount of bleeding. After 15 days if the ultrasound findings showed residual tissue, curettage would be performed. In the surgical group dilatation and sharp curettage was performed. Patient’s data such as age, gravidity, gestational age based on LMP and sonography, previous cesarean and previous abortion was recorded in a data chart. Statistical analysis was performed using X2 analysis, McNemar, Fisher exact test and T–Test. In medical group 87.5% had complete abortion without any need of curettage. In 92.5% of cases in surgical group, gestation products were evacuated completely by curettage. Bleeding period in medical group was significantly more than surgical group but there was no significant difference in hemoglobin concentration level before and after abortion. The most common side effect in medical group was lower abdominal pain and fever. Misoprostol is an effective method with tolerable side effect for terminating missed abortion until 12 weeks, in the other words, it is recommended to use misoprostol as a medical method for terminating first trimester pregnancies in Iran.