Out patient medical management of anembryonic pregnancy using misoprostol

ABSTRACT

This study aims to evaluate the efficacy, safety and acceptability of misoprostol for outpatient management of anembryonic pregnancy. This was a prospective observational study. This study was conducted in the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital Peshawar from Dec. 2011 to Nov. 2012. Over a study period of one year 100 women attending our unit with ultrasound proven anembryonic pregnancy of < 10 weeks' gestation and opting to have medical management and consented to have it on an outpatient basis were recruited for the study. All patients were given 800 micro g of misoprostol intra-vaginally in the unit and advised to take two further doses of 400 micro g of misoprostol, orally, 3 hours apart, the following day at home. Outcome measures included success rates, emergency admission rates, pain scores, satisfaction level, incidence rates of side - effects and number of women who would choose medical management in future. Of the 100 women with anembryonic pregnancy, over three - quarters [n = 88, 88%] of the women achieved successful complete medical evacuation. Overall 6 [6%] women presented for emergency admission. Eighty eight patients were satisfied with the management. The mean visual analogue scale [VAS] score of all women was 6.9. Eighty seven said that they would choose to have medical evacuation in a future miscarriage. A total of 85 women said they would prefer to have the treatment at home rather than in the hospital. No serious side effect was reported with misoprostol. It was concluded that medical evacuation of anembryonic pregnancy is effective, safe and acceptable in the outpatient setting: