Abstract
In this study, we examined the impacts of vaginal misoprostol versus curettage in treatment of early pregnancy failure in women with first time pregnancy. Sixty (60) pregnant women (30 women in misoprostol and 30 subjects in curettage group) with mean age of 25.8 ± 5.3 were enrolled in the research. Early pregnancy failure (less than 12 weeks) was confirmed by trans-vaginal sonography. Eight hundred (800 µg) of misoprostol was applied in posterior fornix of vagina and if there was failure to first prescription, second dose of misoprostol was applied after 24 h. Data were analyzed by chi square and T-test. In misoprostol group; 5 women (17.2%) in first 24 h, 14 subjects (48.2%) in 48 h and 3 participants (10.3%) in 7 days had complete treatment. Seven women (24.1%) had failure to misoprostol application. In curettage group, all of the patients received successful treatment. Hematocrit (HCT) before and after treatment in curettage group was 37.8 ± 1.4 and 35.6 ± 1.3, respectively while in misoprostol group, the HCT before treatment was 38.5 ± 1.5 and changed to 36.1 ± 1.6 after treatment. With considering type of therapy, there was significant differences between HCT level before and after treatment (p = 0.02). Negative βhCG was observed after 3.3 ± 0.5 weeks in the curettage group while it was 3.5 ± 0.5 weeks for misoprostol group. There was no significant change in this regard (p = 0.3). Application of vaginal misoprostol can be used as treatment in early pregnancy failure but curettage is superior. Key words: Early pregnancy failure, misoprostol, curettage.
Highlights
Pregnancy failure is a common complication, and about one of every four women experiences it
In surgical group with curettage, all cases had successful treatment which was confirmed by trans-vaginal sonography, and we did not see any pregnancy residue, whereas in medical therapy, 7 cases (24.1%) had failure to therapy
Successful treatment in medical group was observed in 5 cases (17.3%) within 24 h, 14 cases (48.2%) within 48 h and 3 cases (10.3%) within 7 days
Summary
Pregnancy failure is a common complication, and about one of every four women experiences it. The standard method of encounter with early pregnancy failure has been dilatation and curettage Graziosi et al, 2004; McNamee et al, 2012; Kulier et al, 2011). Due to complications such as bleeding, damage to the uterus (uterine perforation) and cervical injury or Asherman's syndrome, it seems non-surgical treatment for miscarriage is more appropriate (Tang and Ho, 2006). Misoprostol is a synthetic analog of prostaglandin E1. It has been widely used for medical abortion, cervical preparation before surgical abortion, induction of labor and is used to terminate pregnancy (Graziosi et al, 2005).
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