Mid-Trimester Termination of Pregnancy by Vaginal Misoprostol in Missed Abortion

Abstract

The use of vaginal misoprostol, a prostaglandin analogue is an effective and safe management option for missed abortion. This study evaluated a low-dose (200 microgram) vaginally administered misoprostol four hourly to assess the success rate of medical management in mid-trimester missed abortion. A total of fifty patients with missed abortion, who had agreed to undergo medical treatment with vaginal misoprostol were enrolled. They were apparently healthy, between 18-40 years of age, less than 20 weeks of gestation, and had missed abortions verified by ultrasonogram report. All study women with missed abortion; misoprostol tablet (200 microgram) was applied in the posterior fornix of the vagina every four hourly. Complete abortion was confirmed by passage of products of conception and by clinical finding at the pelvic examination along with ultrasonogram report. In this study, we have demonstrated that 92% of patients were successfully treated by vaginal misoprostol. Only one patient needed oxytocin drip and three patients were managed by evacuation and curettage. This study showed that vaginal misoprostol is safe and effective method of treatment for mid-trimester missed abortion.