Arch Gynecol Obstet. 2013 May 26. [Epub ahead of print]

An approach to evaluate the efficacy of vaginal misoprostol administered for a rapid management of first trimester spontaneous onset incomplete abortion, in comparison to surgical curettage

Patua B, Dasgupta M, Bhattacharyya SK, Bhattacharya S, Hasan SH, Saha S
Department of Gynecology and Obstetrics, North Bengal Medical College, Darjeeling, India

PURPOSE: The purpose of this study is to evaluate the efficacy and safety of the medical method in the management of first trimester spontaneous onset incomplete abortion, by using misoprostol vaginal tablets, in comparison to surgical evacuation, with an intention of completing the procedure within 24 h.

METHODS: In this prospective, randomised study of 100 women admitted with features suggestive of incomplete abortion, 50 women received misoprostol vaginal tablets, while another 50 underwent suction curettage of products of conceptus. They were followed up after 24 h of last dosage of misoprostol or surgical intervention. Statistical analysis was done with respect to efficacy, safety and procedure-related side effects.

RESULTS: In this study, when analysed after 24 h of treatment allocation, the efficacy of misoprostol was 91.3 %, and the efficacy of the surgical method was 96 %, with the statistical difference being insignificant. Procedure-related blood loss and pain perception between the two groups were statistically insignificant. However, the incidence of fever in the misoprostol group statistically appeared higher.

CONCLUSIONS: Misoprostol could be a safe and easily accessible alternative to surgical evacuation, in cases of first trimester spontaneous onset incomplete miscarriage, and could be administered by the patient herself at home