Incomplete abortion: a randomized controlled trial comparing expectant with medical management using oral misoprostol

ABSTRACT

This study was carried out on 160 women who had incomplete first trimester miscarriages and consented to pretreatment randomization to compare the efficacy of medical management using oral misoprostol with expectant management. The patients were randomized to treatment with misoprostol 400 microgram [ug] orally every four hours for maximum three doses [n = 80] or expectant management [n = 80] and were re- evaluated 24 hours later. If retained intrauterine products of conception were found with anteroposterior diameter above 15 mm on transvaginal ultrasound, surgical evacuation of the uterus was performed. 47.5% of the women randomized to oral misoprostol treatment and 2.5% of those randomized to expectant management had an empty uterine cavity after 24 hours. Less side effects necessitating management had been observed with the use of misoprostol orally. It was concluded that treatment with oral misoprostol compared with expectancy alone can reduce the demand for surgical evacuation in cases of incomplete abortion by a clinical important degree and its use was associated with fewer medical complications