High-dose misoprostol used in outpatient management of first trimester spontaneous abortion.
OBJECTIVE
The aim of this study was to evaluate the efficacy and tolerance of a high dose of vaginal misoprostol for outpatient medical management of missed abortion.


METHODS
Three doses of 400 mug misoprostol were administered intravaginally every 4 h daily, for a maximum period of 3 days, to 108 women with uneventful first trimester pregnancy failure.


RESULTS
A total of 98 women (90.7%) were managed successfully, with 74 (68.5%) of them within the first 24 h. The mean dose of misoprostol administered was 1,113.0 microg (range 400-3,600 microg), and the mean time required was 19.5 h (range 7-65 h). Only 6 out of 108 women (9.3%) required surgical intervention as the result of retained products of conception. The side effect profile was minimal.


CONCLUSIONS
This protocol of 400 mug intravaginally misoprostol every 4 h as three daily doses for a maximum of 3 days, may offer an efficacious and safe alternative to the outpatient management of first-trimester missed abortion.
Sifakis
Stavros
S
Department of Obstetrics and Gynecology, University of Crete, 71201 Voutes, Heraklion, Crete, Greece. sifakis@excite.com
Angelakis
Emmanuel
E
Vardaki
Elpida
E
Fragouli
Yvoni
Y
Koumantakis
Eugenios
E
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000030:Abortion, Missed / Q000188:drug therapy*; D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010045:Outpatients; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol