Ammara Kashif, Jaweria Faisal, Zobia Jawad, Fatima Chaudhry Inayat, Nargis Shabana, Sadia Kanwal

Comparison of Vaginal Misoprostol with Suction Evacuation for Management of 1st Trimester Spontaneous Miscarriage

Ammara Kashif, Jaweria Faisal, Zobia Jawad, Fatima Chaudhry Inayat, Nargis Shabana, Sadia Kanwal



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ABSTRACT

 

Aim: To compare the management outcomeof vaginal Misoprostol with suction evacuation for treatment of 1st trimester spontaneous miscarriages.

Study Design:Quasi Experimental Study.

Place and duration of study: Mother and Child health center, PIMS Islamabad, from Aug 2011 to Aug 2012.

Methodology:Total 60 women with early pregnancy failure were recruited in this study. These women weredivided randomly into two groups i.e., Group A and Group B. Group A received medical management i.e. vaginal Misoprostol 800µg (4 Tablets of Cytotec 200 micrograms each) repeated after an interval of 24 hours once if needed and Group B underwent surgical intervention by suction evacuation. Main outcome measures were, mean management time, complete evacuation of products of conception, appearance of side effects and comparison of the costs.

Results: In Group A total of 73.3% and in group B100% patients had complete evacuation.The management time was 35 hoursin group A and 16 hours in Group B. Misoprostol insertion resulted in heavy vaginal bleeding and abdominal pain in 20 (66.7%), fever in 3 (10%)and vomiting in 2 (6.7%), patients. Only one patient (3.3%) had vomiting, pain and bleeding in Group B. The cost of medicine in Group A was Rs 280 and in Group B it was Rs 1500.

Conclusion:Surgical evacuation is costly but better than medical treatment in terms of complete evacuation in less time with minimal side effects.

Keywords:Misoprostol, suction evacuation, missed abortion. Termination of pregnancy, early pregnancy loss, 



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