Missed abortion: Termination using single-dose versus two doses of vaginal misoprostol tablets

To determine the effectiveness of 400 micro g misoprostol, administered vaginally as single-dose, compared to repeating the same drug, six hours later, for termination of missed abortion. One hundred ninety eight women with missed abortion were enrolled in this study. They had presented to Prince Zeid, Prince Rashed and Queen Alia Military Hospitals from June 1, 2005 to September 30, 2006 for termination of pregnancy. The gestational ages ranged between 9-22 weeks. Ninety three women were assigned to the single-dose group [Group-I] while the rest were given two doses of 400 micro g misoprostol, six hours apart [Group-II]. The success rate for Group-I was approximately 88% compared to around 94% in Group-II. In Group-I, of all the women who aborted, about 50% had complete abortion compared to 66% in Group-II. The average time interval from the start of termination to expulsion of conception was around 13 hours in Group-I and 9 hours in Group-II [p <0.05]. Only minimal adverse effects were noted. Two doses of 400 micro g misoprostol administered vaginally did not prove to be superior to a single dose for termination of missed abortion, however, more women who had a successful procedure in Group-I needed evacuation and curettage. The mean abortion time was shorter in Group-II

Continous fetal heart rate monitoring and neonatal outcome in low-risk obstetric population

To evaluate the benefits of continuous fetal heart rate monitoring during labour on neonatal outcome in low-risk obstetric population. Setting: Prince Hashem Military Hospital, Zarqa, Jordan. Materials and This study was conducted at Prince Hashem Military Hospital during the period Jaunary 1st until March 31st 2000, on 200 low-risk women, divided evenly and randomly into two groups. In group I, the women had continous fetal heart monitoring while in group II, intermittent auscultation with the sonic aide was used. Abnormal fetal heart rate patterns, need for operative delivery for fetal distress, perinatal morbidity and mortality and Apgar scores were assessed. Abnomralities in fetal heart rate were detected in 54% of the continously monitored group and in 9% of the routinely monitored group. More operative deliveries were performed in the monitored than in the control group. The incidence of caesarean section in both groups was low [6% and 3% respectively]. No significant difference was found in the Apgar score and neonatal outcome in both groups. This study demonstrated that continuous fetal heart rate monitoring should not be used as a routine in all labours. Furthermore, continuous fetal heart rate monitoring failed to demonstrate any improvement in perinatal outocme in a low-risk obstetric population