Medical Termination of First Trimester Miscarriages

Objective: To study the success rate of medical termination of first trimester non viable pregnancies with misoprostol 1200 mu g.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 1200 mu g 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 recmited 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 1200 mu g of misoprostol orally for management of missed, incomplete and an embryonic miscarriage.