A comparison of vaginal misoprostol 800 microg versus 400 microg for anembryonic pregnancy: a randomized comparative trial.

ABSTRACT

OBJECTIVE: To compare the efficacy, side effects and patient satisfaction between 800 microg versus 400 microg intravaginal misoprostol for anembryonic pregnancy. MATERIAL AND METHOD: Women who had diagnosed as anembryonic pregnancy were treated as IPD case and randomly assigned to receive either 800 microg or 400 microg intravaginal misoprostol. The second dose was administered in the equal dose if there was no evidence of abortion in 24 hr. The treatment failure was determined by no complete abortion within 48 hr. If spontaneous abortion had not occurred, or had heavy vaginal bleeding or evidence of incomplete abortion either by clinical manifestation or sonographic finding then dilatation and curettage was performed. RESULTS: Fifty patients were enrolled into the study, 25 patients were randomized to receive 800 mg and 25 patients were received 400 mg intravaginal misoprostol. Complete abortion within 48 hr was not different between the 2 groups (72%). However complete abortion within 12 hr was significantly higher in the 800 mg group than in the 400 mg group (64% versus 20%, respectively, p = 0.016). The median time to abortion in the 800 mg group was significantly shorter than in the 400 mg group (9.0 hr versus 16.0 hr, respectively, p = 0.01). There was no significant difference in the side effects and patients' satisfaction between both groups. CONCLUSION: Vaginal misoprostol can be used for termination of pregnancy in case of anembryonic pregnancy with high successful rate of complete abortion and no serious adverse effects. We recommend the 800 microg vaginal misoprostol regimen because within 12 hr the complete abortion rate was higher and the median time to abortion was shorter than the 400 microg regimen with no difference in side effects. This may decrease the suffering time of both physical and psychological trauma to the patient before complete abortion has occurred.