Oral misoprostol reduces vaginal bleeding following surgical evacuation for first trimester spontaneous abortion

Abstract

Objective To assess the effectiveness and tolerability of misoprostol to reduce the amount and duration of vaginal bleeding following surgical evacuation for first trimester spontaneous abortion. Methods A total of 160 patients who underwent surgical evacuation for first trimester spontaneous abortion between 8 and 12 weeks of pregnancy were randomized into 2 groups to receive either 200 µg of oral misoprostol immediately after evacuation followed every 6 hours for 48 hours or no misoprostol. Pain scores, duration and amount of bleeding, and endometrial thickness were assessed over 10 days. Results Women who received misoprostol had significantly fewer bleeding days after evacuation (4.11 ± 2.69 vs 5.89 ± 3.06; P < 0.001), fewer patients reported vaginal bleeding lasting 10 days or more (3.8% vs 15.0%; P = 0.014), and endometrial thickness 10 days after evacuation was less (6.25 ± 2.38 vs 7.23 ± 1.94; P = 0.05). Pain scores were comparable in both groups (1.54 ± 0.65 vs 1.63 ± 0.83; P = 0.40) after 10 days. Conclusion Oral misoprostol is effective in reducing the prevalence and amount of vaginal bleeding after surgical evacuation for first trimester spontaneous abortion.