Medical management of missed abortion: a randomized clinical trial.
Obstet Gynecol
; 99(4): 563-6, 2002 Apr.
Article
in En
| MEDLINE
| ID: mdl-12039111
ABSTRACT
OBJECTIVE:
To estimate the efficacy of vaginal misoprostol for medical management of missed abortion.METHODS:
Fifty women with missed abortion were randomized to treatment with up to two 800 microg [DOSAGE ERROR CORRECTED] doses of misoprostol vaginally or a placebo. Participants were reviewed daily for 2 days, then again at 1 week. A blood sample for hemoglobin and serum beta-human chorionic gonadotropin (beta hCG) was obtained on day 1 and the hemoglobin level checked again on day 7. Complete abortion was defined as expulsion of the products of conception without dilation and curettage (D&C) and a negative follow-up urine beta hCG test after 4 weeks, or as no products of conception obtained at D&C in cases of suspected incomplete abortion.RESULTS:
The rate of complete abortion was 80% (20 of 25) in the misoprostol group and 16% (four of 25) in the placebo group, relative risk 0.20 (0.08, 0.50), P <.001. The rate of D&C was 28% (seven of 25) in the misoprostol group and 84% (21 of 25) in the placebo group, relative risk 0.33 (0.17, 0.64), P <.001. One participant in the misoprostol group had an emergency D&C for heavy bleeding. No participants required blood transfusion. The mean reduction in hemoglobin from day 1 to day 7 was 3.2 g/L in the misoprostol group versus 4.3 g/L in the placebo group, P = .72. Patient satisfaction with misoprostol treatment was high with 19 of 21 participants reporting they would try medical management again if they experienced another missed abortion.CONCLUSION:
Medical management of missed abortion is effective, reduces the need for D&C, and is associated with high levels of patient satisfaction.
Search on Google
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Misoprostol
/
Abortion, Missed
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Obstet Gynecol
Year:
2002
Document type:
Article
Affiliation country:
Canada