Medical Termination of First Trimester Miscarriages

Objective: To study the success rate of medical termination of first trimester non viable pregnancies with misoprostol 1200µg.The secondary end points were to study the prevalence of unwanted side effects. Study design : Interventional: Quasi experimental study. Setting: Department of Obstetrics & Gynaecology. Fatima Memorial Hospital Lahore. Study duration:   18 months (July 05 to January 07). Sample technique : Non-probable sampling: Purposive. Sample : Eighty one women seeking medical attention for early miscarriages. Method : Women with non viable, first trimester miscarriage were selected for termination with misoprostol 1200µg in divided doses over 24 hours. Main outcome measures: Main outcome measure was the proportion of successful resolution of miscarriage without surgical intervention. Secondary outcomes were incidence of pain, heavy vaginal bleeding (>500ml), infection, pyrexia and gastrointestinal side effects. Results: Eighty-one women were recruited in the study. Treatment was successful in 43 patients (53.1%) with 38 patients (46.9%) requiring surgical evacuation due to failure of treatment. Major side effect experienced by patient was pain (42.0%) requiring analgesia for relief. Nausea and vomiting was seen in (18.5%). Two patients (2.5%) had diarrhea and three patients (3.7%) had pyrexia. Five patients (6.2%) had heavy vaginal bleeding (>500ml). None had PID. Conclusion : Medical treatment of first trimester miscarriage is non-invasive and cost effective method of treatment and a safe alternative to D&C. Our study demonstrated the efficiency and safety of administration of 1200μg of misoprostol orally for management of missed, incomplete and an embryonic miscarriage. Keywords: Misoprostol, medical management, miscarriage.