ABSTRACT
Objective: to compare the outcome of medical vs. surgical management of missed abortion in terms of success rate and complications
Material and Methods: all the participants were admitted in hospital gynecology ward and were divided into two groups. 55 women were randomly selected to undergo surgical management i.e. D and C and 75 women to receive medical treatment with oral misoprostol 400?gm thrice daily for 2 days. If the patient did not expel products of conception during 48 hours, her medical management was considered to be failed and surgical evacuation was done. Data collection was done on a structured Performa which was then entered on excel Data sheet and analyzed on spss20 statistical package
Results: Surgical management was successful in 100% cases. Complications were more with surgical management i.e. nausea, vomiting, postoperative fever, lower abdominal pain, excessive bleeding, need for blood transfusion and genital tract trauma. Medical management had a lower success rate, evacuation was sometimes incomplete and patient had to experience labor pains but it had lower complication rate. D and C was easier in medical management group. Patient acceptability was more for medical group
Conclusion: surgical management has a high success rate but its complications are more as compared to medical management. Surgical evacuation as first line treatment option is only suitable for a woman who does not wish to undergo labor discomfort .Medical termination is -easier to manage, more natural, associated with least complications and more acceptable by the patients but its success rate is slightly less as compared to surgical intervention. Hence each patient should be given the chance of medical termination for at least two days and if she does not expel products of conception spontaneously during this time, then only surgical evacuation should be done