ABSTRACT

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