title: 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.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. ostang@graduate.hku.hk
authors.forename: Oi Shan
authors.initials: OS
authors.lastname: Tang
authors.forename: Charas Y T
authors.initials: CY
authors.lastname: Ong
authors.forename: Ka Yu
authors.initials: KY
authors.lastname: Tse
authors.forename: Ernest H Y
authors.initials: EH
authors.lastname: Ng
authors.forename: Sharon W H
authors.initials: SW
authors.lastname: Lee
authors.forename: Pak Chung
authors.initials: PC
authors.lastname: Ho
mesh_terms: 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
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol