Comparison of vaginal with vaginal plus oral prostaglandine E1 in medical treatment of missed abortion in first trimester

Missed abortion, due to its severe complications, has both medical and surgical treatments. Because of surgical complications, medical treatment has recently more commonly used. As misoprostol (a prostaglandin E1 analogue) has oral route formulation, low expense, ease of administration and quick effect, has been widely prescribed. The aim of this study was to compare the effectiveness of misoprostol when given by vaginal with that given both vaginal plus oral misoprostol in the treatment of missed abortion in the first trimester. Subjects and

In this clinical trial, which was performed during 2007, 98 patients with missed abortion who were referred to Ahvaz Imam Khomeini and Razi hospitals were enrolled and divided into two groups with 49 patients in each. Group I was prescribed 800 g of vaginal misoprostol and every 12-24 hours, an additional 800 g was administered. Group II was prescribed 400 g of oral and 400 g of vaginal misoprostol simultaneously with additional 400 g of vaginal misoprostol every 8 hours. For analysis of the data ANOVA and Chi squared tests and SPSS 13 software were used.

Vaginal bleeding started significantly sooner in group I than group II 4 hour and 23 minute in contrast to 7 hour and 2 minute (P< 0.05). Group I expelled gestational products more than group 39(76/5%) in contrast to12(23/5%) (P< 0.05). Patients in group I had less complications including nausea, vomiting, diarrhea, fever than the patients in group II (P<0.01).

The overall results of this study confirms the previous studies that misoprostol is an effective drug in controlling complications of first trimesters missed abortions. Furthermore vaginal route of administration is preferable method to vaginal plus oral route for treatment of missed abortion.