Misoprostol in the management of missed abortion.
OBJECTIVE
To compare the effect of vaginal misoprostol with that of placebo when used prior to dilation and aspiration in women with a missed abortion.


METHODS
Eighty-four pregnant women with a missed abortion were randomized to receive either vaginal misoprostol (200 micrograms) or placebo the day before the planned dilatation and aspiration under inhalation anesthesia.


RESULTS
Thirty-five women (83.33%) in the misoprostol group and 6 women (17.14%) in the placebo group aborted spontaneously prior to the scheduled dilatation and aspiration, P < 0.0001. The mean insertion to spontaneous expulsion time was 11.63 +/- 6.14 h in the misoprostol group compared to 11.95 +/- 5.43 h in placebo. In the misoprostol group two women required intramuscular pethidine for analgesia. In the placebo group there were two cases of blood loss in excess of 500 ml and one woman with a uterine perforation.


CONCLUSIONS
Vaginal administration of misoprostol to women with a missed abortion produced spontaneous expulsion of the pregnancy and reduced the need for surgical treatment.
Herabutya
Y
Y
Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
O-Prasertsawat
P
P
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000030:Abortion, Missed / Q000628:therapy*; D000282:Administration, Intravaginal; D000328:Adult; D002584:Cervix Uteri; D004106:Dilatation / Q000379:methods; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000627:therapeutic use*; D011247:Pregnancy
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol