Medical management of early pregnancy failure in a patient with coronary artery disease.
OBJECTIVE
To describe a case of early pregnancy failure in a patient who was not an optimal candidate for suction aspiration because of her body habitus and history of a myocardial infarction that was treated medically with misoprostol.


METHODS
Case report.


METHODS
Academic tertiary-care hospital.


METHODS
A 43-year-old woman with morbid obesity, coronary artery disease, previous myocardial infarction, obstructive sleep apnea, and other medical problems who presented with an early pregnancy failure.


METHODS
Medical management with 800 microg of vaginal misoprostol in an inpatient setting with cardiac monitoring.


METHODS
Ultrasonographic resolution of intrauterine pregnancy, vaginal bleeding, and cardiac events.


RESULTS
No gestational sac was visualized by ultrasound on the second hospital day, the patient's hemoglobin value at discharge was 12.1 mg/dL, and no adverse cardiac events occurred.


CONCLUSIONS
Medical management with misoprostol on an inpatient basis is a possible alternative to dilation and curettage in patients with complex medical problems and early pregnancy failure.
Hackney
David N
DN
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. dhackney@mail.magee.edu
Creinin
Mitchell D
MD
Simhan
Hyagriv
H
D000027:Abortion, Incomplete / Q000188:drug therapy*; D000328:Adult; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*
D016595:Misoprostol