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Hum. Reprod. Advance Access published online on September 9, 2005
Human Reproduction, 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.
Received June 9, 2005
Revised August 7, 2005
Accepted August 16, 2005

Article

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 Tang 1*, Charas Y.T. Ong 1, Ka Yu Tse 1, Ernest H.Y. Ng 1, Sharon W.H. Lee 1, and Pak Chung Ho 1

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

* To whom correspondence should be addressed.
Oi Shan Tang, E-mail: ostang{at}graduate.hku.hk


  Abstract

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 3g 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.

Keywords: first trimester/miscarriage/misoprostol/sublingual.
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