Combined administration of misoprostol in the first and second trimester missed abortion cases.

OBJECTIVE: We aimed to investigate the effectiveness and adverse effects of combined (vaginal + oral) administration of misoprostol in missed abortion cases. MATERIAL AND METHODS: 48 missed abortion cases between 8 and 20 weeks of gestation were enrolled in this study. Misoprostol-induced medical abortion was planned; the first dose (200 microg) was administered intravaginally and subsequent doses (200 microg each) orally every following hour. A maximum of six doses (1200 microg) were used. Revision curettage was performed on all subjects who aborted. RESULTS: The mean time interval from the first dose of misoprostol until the abortion was 6.27 +/- 3.02 hours. The success rate was 95% for the whole group. We observed misoprostol-related trembling in one patient and fever in two patients. CONCLUSION: We believe that our low-dose combined misoprostol protocol is a safe, effective and well-tolerated method with minimal adverse effects for the termination of both first and second trimester pregnancy losses.