Background: Surgical evacuation has been used as a standard treatment procedure for missed abortion, but it is an invasive technique. So medical treatments have been introduced for this problem using vaginal Misoprostol tablets. In this study, we tried to evaluate misoprostol therapeutic effects in patients with missed abortion, admitted in Mirza koochak Khan Hospital (2000-2001) in Tehran.
Materials and Methods: In this quasi experimental study 60 patients with missed abortion were selected by simple sampling and were divided into two groups: 30 patients with amenorrhea <13 weeks and 30 patients with amenorrhea at 13 weeks. 200 mcg vaginal Misoprostol was applied to posterior fornix and this was repeated every 4 hours for a maximum of four doses until complete expulsion of products of conception happened. Effects and side effects of these tablets were evaluated in all patients and compared in two groups. All data were analyzed using t-test and chi-square tests.
Results: 40 women experienced complete abortion (63% in group 1 and 16.7% in group 2) (P<0.0001). The frequency of profuse bleeding and administration of oxytocin for control of bleeding in group 2 (with more prolonged amenorrhea) was more than in group 1 (P<0.05). Other complications including fever, diarrhea, nausea and pain appeared to be similar in two groups. Background parameters such as age, number of taken pills, and the time spent for abortion were also similar in two groups. Patients in group 2 had a higher number of pregnancies and deliveries in their history.
Conclusion: Vaginal Misoprostol could be effective in the management of missed abortion specifically in patients who have had amenorrhea for less than 13 weeks. According to non-invasiveness of this method and low costs, it is recommended for missed abortions (<13 weeks) as the first-line treatment.
Type of Study:
Original Article |
Received: 2008/09/28 | Accepted: 2017/06/18 | Published: 2017/06/18