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Hum. Reprod. Advance Access originally published online on September 9, 2005
Human Reproduction 2006 21(1):189-192; doi:10.1093/humrep/dei303
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

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

Oi Shan Tang1, Charas Y.T. Ong, Ka Yu Tse, Ernest H.Y. Ng, Sharon W.H. Lee and Pak Chung Ho

Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China

1 To whom correspondence should be addressed at: 6/F, Professorial Block, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong SAR, China. E-mail: ostang{at}graduate.hku.hk

BACKGROUND: This randomized controlled trial compared the use of sublingual misoprostol with or without an additional 1 week course of sublingual misoprostol for the medical management of silent miscarriage. METHODS: A total of 180 women who had silent miscarriage (<13 weeks) was given 600 µg of misoprostol every 3 h for a maximum of three doses. These women were randomized into two groups: (i) no extended course of misoprostol or (ii) an extended course of sublingual misoprostol 400 µg daily for 1 week. The primary outcome measure was complete miscarriage rate. RESULTS: The success rates for complete miscarriage were similar in both groups (group 1: 92.2%; 95% CI: 86.1–97.5% and group 2: 93.2%; 95% CI: 84.6–96.8%). There were no serious complications. The incidence of diarrhoea was higher (P < 0.01) in the group with an extended course of sublingual misoprostol. Other side-effects were similar. CONCLUSION: Sublingual misoprostol is useful for the management of silent miscarriage. An additional 1 week course of sublingual misoprostol did not improve the success rate or shorten the duration of vaginal bleeding. Instead, it increased the incidence of diarrhoea.

Key words: first trimester/miscarriage/misoprostol/sublingual


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