A randomized trial to compare the use of sublingual misoprostol with or without an additional 1 week course for the management of first trimester silent miscarriage.
BACKGROUND
This randomized controlled trial compared the use of sublingual misoprostol with or without an additional 1 week course of sublingual misoprostol for the medical management of silent miscarriage.


METHODS
A total of 180 women who had silent miscarriage (<13 weeks) was given 600 microg of misoprostol every 3 h for a maximum of three doses. These women were randomized into two groups: (i) no extended course of misoprostol or (ii) an extended course of sublingual misoprostol 400 microg daily for 1 week. The primary outcome measure was complete miscarriage rate.


RESULTS
The success rates for complete miscarriage were similar in both groups (group 1: 92.2%; 95% CI: 86.1-97.5% and group 2: 93.2%; 95% CI: 84.6-96.8%). There were no serious complications. The incidence of diarrhoea was higher (P < 0.01) in the group with an extended course of sublingual misoprostol. Other side-effects were similar.


CONCLUSIONS
Sublingual misoprostol is useful for the management of silent miscarriage. An additional 1 week course of sublingual misoprostol did not improve the success rate or shorten the duration of vaginal bleeding. Instead, it increased the incidence of diarrhoea.
Tang
Oi Shan
OS
Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. ostang@graduate.hku.hk
Ong
Charas Y T
CY
Tse
Ka Yu
KY
Ng
Ernest H Y
EH
Lee
Sharon W H
SW
Ho
Pak Chung
PC
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000022:Abortion, Spontaneous / Q000188:drug therapy*; D000286:Administration, Sublingual; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014621:Vagina / Q000473:pathology
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol