VAGINAL MISOPROSTOL IN THE MANAGEMENT OF FIRST TRIMESTER MISSED ABORTION

ABSTRACT
Objective: To assess the efficacy and side effects of vaginal misoprostol in termination of first trimester missed abortions.
Materials and Methods: This study was conducted from April 2015 to March 2016 at Gynae Unit, Naseer Teaching
Hospital Peshawar.
A total of 52 patients, with first trimester missed abortion were included. Misoprostol (400mcg) was inserted vaginally
and the second dose of 800mcg of misoprostol in case passage of tissues did not occur with the first dose. Without
successful abortion in 48hrs, misoprostol administration was abandoned in favor of surgical induction. Main outcome
measures of the study were induction –expulsion interval, complete expulsion of products of conception and side
effects of misoprostol.
Results: Successful abortion was seen in 45(86.5%) patients. Seven patients ended up in surgical evacuation. Of these
4 patients had incomplete abortion and 3 had failed induction.
Side effects included abdominal cramps (3.8%), nausea, vomiting (5.7%) and diarrhea (1.9%).
Conclusion: Misoprostol is highly effective in inducing successful abortion without any major increase in side effects.
Key words: Misoprostol, Missed Abortion, Anembryonic Pregnancy, Medical Abortion.