Human Reproduction, Vol. 16, No. 7, 1493-1496,
July 2001
© 2001 European Society of Human Reproduction and Embryology
Vaginal misoprostol as medical treatment for first trimester spontaneous miscarriage
Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China
BACKGROUND: Misoprostol is effective for cervical priming prior to suction evacuation in first trimester pregnancy termination. This is the first randomized study to compare vaginal misoprostol versus expectant treatment in women presenting with spontaneous miscarriage. METHODS: Sixty women presenting with spontaneous miscarriage were recruited to the study at the Queen Mary Hospital between 1998 and 1999. They were randomized to group 1: misoprostol; and group 2: expectant management. Women in the misoprostol group received vaginal misoprostol 400 µg on days 1, 3 and 5. The expectant group was followed up according to the same schedule. Suction evacuation was performed if there was excessive bleeding or abdominal pain; or if a gestational sac was detected by transvaginal scan on day 15. RESULTS: Fifty-nine women completed the trial. Those who did not require suction evacuation up to the time of return of normal menstruation were considered to be successful. The incidence of side-effects was comparable between the two groups. Three women in the expectant group and one in the misoprostol group underwent emergency suction evacuation because of excessive bleeding. The mean duration of vaginal bleeding was similar for both groups (14.6 days in the misoprostol group versus 15.0 days in the expectant group). The successful rate in the misoprostol group was significantly higher than that of the expectant group (83.3 versus 48.3%, P < 0.05). CONCLUSION: We recommend repeated vaginal misoprostol 400 µg given on days 1, 3 and 5 as a treatment option for women with first trimester spontaneous miscarriage.
Key words: expectant management/misoprostol/randomized trial/spontaneous miscarriage
1 To whom correspondence should be addressed. E-mail: cora{at}hkucc.hku.hk
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J Trinder, P Brocklehurst, R Porter, M Read, S Vyas, and L Smith Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) BMJ, May 27, 2006; 332(7552): 1235 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. S. Tang, C. Y.T. Ong, K. Y. Tse, E. H.Y. Ng, S. W.H. Lee, and P. C. Ho A randomized trial to compare the use of sublingual misoprostol with or without an additional 1 week course for the management of first trimester silent miscarriage Hum. Reprod., January 1, 2006; 21(1): 189 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H.S. You and T. K.H. Chung Expectant, medical or surgical treatment for spontaneous abortion in first trimester of pregnancy: a cost analysis Hum. Reprod., October 1, 2005; 20(10): 2873 - 2878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Winikoff Pregnancy Failure and Misoprostol -- Time for a Change N. Engl. J. Med., August 25, 2005; 353(8): 834 - 836. [Full Text] [PDF]
|
|
|
|
|
|
G.C.M. Graziosi, B.W.J. Mol, P.J.H. Reuwer, A. Drogtrop, and H.W. Bruinse Misoprostol versus curettage in women with early pregnancy failure after initial expectant management: a randomized trial Hum. Reprod., August 1, 2004; 19(8): 1894 - 1899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.S. Bagratee, V. Khullar, L. Regan, J. Moodley, and H. Kagoro A randomized controlled trial comparing medical and expectant management of first trimester miscarriage Hum. Reprod., February 1, 2004; 19(2): 266 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. S. Tang, W. N. T. Lau, E. H. Y. Ng, S. W. H. Lee, and P. C. Ho A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages Hum. Reprod., January 1, 2003; 18(1): 176 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. S. Tang, S. W.H. Lee, and P. C. Ho A prospective randomized study on the measured blood loss in medical termination of early pregnancy by three different misoprostol regimens after pretreatment with mifepristone Hum. Reprod., November 1, 2002; 17(11): 2865 - 2868. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Wieringa-de Waard, J. Vos, G. J. Bonsel, P. J.E. Bindels, and W. M. Ankum Management of miscarriage: a randomized controlled trial of expectant management versus surgical evacuation Hum. Reprod., September 1, 2002; 17(9): 2445 - 2450. [Abstract] [Full Text] [PDF]
|
|