Single Vaginal Dose of 800 μg Misoprostol for Termination of First Trimester Spontaneous Incomplete or Missed Miscarriage

Abstract

Background: Vaginal misoprostol have been used for of first trimester miscarriage. But studies are lacking an ideal effective dose, frequency and patient's satisfaction. This study was done to evaluate the effectiveness and side effects of a single vaginal dose of 800 μg misoprostol for termination of first trimester miscarriage. Materials and Methods: This study was conducted in the Women specialized hospital, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia from October 2010 to May 2012. A prospective study was conducted for 100 pregnant women who were admitted to Women Specialized Hospital, Riyadh, with spontaneous incomplete or missed miscarriage. All admitted patients were given 800 μg of misoprostol as a single vaginal dose. Twenty-four hours after the first dose, patients were evaluated for whether they had a complete miscarriage, went for dilatation and curettage (D&C) or needed a second repeat dose. The mean time from induction to miscarriage, vaginal loss, side effects, and complications were evaluated. Results: A total of 50 patients (50%) had aborted completely after the first dose within the first 24 hours and 5 patients (5%) after the second dose. The mean time to complete miscarriage after the first dose was 7 ± 4.2 hours. The remaining 45 patients (45%) went for emergency D&C due to excessive bleeding and/or the gestational sac not being passed. There were significant reductions in pulse rate, systolic blood pressure and hemoglobin level post misoprostol administration. However, there was no significant difference in diastolic blood pressure and patients were satisfied.