Medical Versus Surgical Treatment of Incomplete First Trimestric Abortion

Abstract

Objective: to assess efficacy and risks of medical treatment of incomplete abortion using misoprostol versus surgical procedures. Methods:  A prospective comparative study included 208 women with incomplete abortion with gestational age between 5th and 12th week randomized equally to two groups Group I received 600 micro gram misoprostol  as single oral dose and Group II underwent surgical dilatation and evacuation. Primary outcome was successful treatment all women give a written acceptance of being involved in the trial. Results:  There was no statistically significant difference between Misoprostol and surgical groups regarding endometrial thickness evaluated after treatment (10.5±2.65 versus. 9.3±1.97 respectively, where P value 0.251Non significant , treatment failure (11 versus. 6 respectively, where P value 0.071 Non significant), those with blood loss more than 500 cc ( 1 versus. 3 respectively, where P value 0.482 Non significant ) and those who needed recurrettage ((11 versus. 6 respectively, where value 0.064 Non significant). Side effects of treatment showed no statistically significant difference between the studied women (fever occurred in 3 versus. 1, IUS in 0 versus. 1 and vomiting occurred in 1 versus. 3 in medical versus. surgical women respectively ,where P value > 0.05)  except diarrhea which was much more common in women under Misoprostol treatment (28 versus. 0 respectively, where value < 0.001).                                                                   Conclusion:  Medical treatment is effective and acceptable and less costly than surgical treatment in women with incomplete abortion.