Medical Treatment of Spontaneous Abortion in the First Trimester

Abstract

Background: The objective was to evaluate the efficacy of medical treatment with misoprostol in spontaneous abortion in the first trimester. The other objectives were to determine the incidence of side effects and complications and identify causes that may motivate medical treatment failure, and to establish the degree of acceptance and patient satisfaction. A cost-effectiveness study was performed. Methods: It was longitudinal, observational, prospective, descriptive and analytic research. We evaluated 680 patients diagnosed with spontaneous abortion of the first trimester, in the period between June 2009 and December 2011 at the Hospital Clinico San Carlos. It was developed a protocol for the administration of medical treatment with misoprostol for those patients who accepted, compared with classic surgery. Results: The success of medical treatment was 81.85%, it was effective in 89.21% of accomplished incomplete abortion, in the 79.52% of deferred abortion and in the 78.46% of anembryonic gestation. There were minor side effects in the 33.59% of patients, declaring satisfaction in 84.99% of patients. With regard to cost study, there was a patient savings €960.54. Conclusions: The success of medical treatment in our study was high, with effective approximately eight out of 10 patients. Misoprostol is highly accepted by patients, declaring most satisfied. The incidence of minor side effects is low, and were well tolerated, so their presence does not seem to restrict the application of such treatment. Its use helps to reduce healthcare costs. J Clin Gynecol Obstet. 2015;4(3):265-270 doi: http://dx.doi.org/10.14740/jcgo335w